Basic Information
| Provider Information | |||||||||
| NPI: | 1104251792 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHREIBER | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | KATHLEEN | ||||||||
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| Credential: | MHS PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 315 MARTIN LUTHER KING JR WAY | ||||||||
| Address2: | M/S 737-3-PCON,737 FAWCETT | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984054234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534598231 | ||||||||
| FaxNumber: | 2534597863 | ||||||||
| Practice Location | |||||||||
| Address1: | 1450 5TH ST SE STE 4200 | ||||||||
| Address2: | |||||||||
| City: | PUYALLUP | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983724604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2537926555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2013 | ||||||||
| LastUpdateDate: | 01/05/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 60696522 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.