Individual
CRAIG M TEDDER
Active
Individual
CRAIG M TEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009225
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013865
—
WA
01
—
3186TE
REGENCE BLUE SHIELD
WA
01
—
462155
LABOR & INDUSTRIES
WA
01
—
710883456-98501-A007
TRICARE
WA
01
—
710883456-98512-A006
TRICARE
WA
01
—
7883504
AETNA
WA
01
—
911745305-98501-A002
TRICARE
WA
Enumeration date
06/02/2006
Last updated
07/10/2023
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