Individual
TERESA VANSANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 N. MEDCALF STREET, MONTESANO, WA 98563
(360) 249-2273
Mailing address
655 S WILLOW ST STE 128, MANCHESTER, NH 03103-5705
(800) 995-2673
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
N160965101
WA
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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