Provider Demographics
NPI:1104251792
Name:SCHREIBER, TERESA KATHLEEN (MHS PA-C)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:KATHLEEN
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:MHS PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:M/S 737-3-PCON,737 FAWCETT
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4234
Mailing Address - Country:US
Mailing Address - Phone:253-459-8231
Mailing Address - Fax:253-459-7863
Practice Address - Street 1:1450 5TH ST SE STE 4200
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4604
Practice Address - Country:US
Practice Address - Phone:253-792-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60696522363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical