Individual
THERESA K WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1500
Mailing address
PO BOX 34584, SEATTLE, WA 98124-1584
(425) 261-1500
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30004339
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9628017
—
WA
Enumeration date
06/17/2006
Last updated
07/08/2007
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