Individual
ROBERT S TEICHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001774
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039597
LABOR AND INDUSTRIES#
WA
05
—
2007359
—
WA
01
—
410038242
RAILROAD MC#
WA
05
—
MD0659W
—
AK
01
—
TE4774
BLUE SHIELD #
WA
01
—
US0861771
AETNA SPECIALIST PIN
WA
Enumeration date
01/15/2007
Last updated
06/17/2008
Update your record
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