Individual
MS. THERESA ANN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7515 LAKEWOOD DR W, LAKEWOOD, WA 98499-3164
(253) 222-4395
Mailing address
7515 LAKEWOOD DR W, LAKEWOOD, WA 98499-3164
(253) 222-4395
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
60130766
WA
Other
Enumeration date
08/07/2017
Last updated
07/21/2022
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