Individual
DR. TEERAWIT SUPAKORNDEJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15418 MAIN ST, MILL CREEK, WA 98012-9030
(425) 339-5417
Mailing address
7600 EVERGREEN WAY, EVERETT, WA 98203-6421
(206) 860-5414
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD61047461
WA
207R00000X
Internal Medicine Physician
2016018207
MO
Other
Enumeration date
06/21/2016
Last updated
07/09/2026
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