Individual
TERESITA A CLAR DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
521 N YOUNG ST, KGH MEDICAL MALL, KENNEWICK, WA 99336-7806
(509) 585-5222
(509) 585-5271
Mailing address
7203 W DESCHUTES AVE, KENNEWICK, WA 99336-7777
(509) 737-1880
(509) 737-1879
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00037685
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8246712
—
WA
Enumeration date
05/19/2006
Last updated
07/12/2010
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