Individual
DR. TEERAWIT SUPAKORNDEJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4004 COLBY AVE, EVERETT, WA 98201-6203
(425) 339-5417
(425) 339-5429
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 339-5417
(425) 339-5429
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
09/14/2020
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