Individual
MS. TEI HABENICHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4409 NW ANDERSON HILL RD, SILVERDALE, WA 98383-6807
(360) 698-6630
(360) 398-7002
Mailing address
4409 NW ANDERSON HILL RD, SILVERDALE, WA 98383-6807
(360) 698-6630
(360) 398-7002
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10004580
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0277669
L&I
WA
05
—
1037226
—
WA
Enumeration date
11/22/2006
Last updated
04/04/2012
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