Individual
ALEX W TEADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
546 N JEFFERSON LN # 301, SPOKANE, WA 99201-7104
(509) 474-1220
(509) 808-2164
Mailing address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634
(208) 277-0795
(208) 277-0775
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60932497
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT60932497
STATE LICENSE
WA
Enumeration date
07/10/2019
Last updated
01/11/2021
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