TERESA L WALLACE (NPI# 1871509646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871509646 |
| Entity Type | Individual |
| Full Name | TERESA L WALLACE |
| Credential | MD |
| Practice Address |
3915 Talbot Rd S Ste 401 Renton WA 98055-5738 |
| Mailing Address |
3600 Lind Ave Sw Ste 100 Renton WA 98057-4934 |
| Practice Telephone | 4256564224 |
| Practice Fax Number | 4056565096 |
| Mailing Telephone | 4256565412 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2012-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD00025633 | WA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235600081 | Teresa Wallace | Licensed Practical Nurse | 2 Rifkin Ct, Spring Valley, NY 10977-2236 | 2018-12-05 |
| 1225357635 | Teresa M Wallace | Nurse Practitioner | 1880 Old Highway 51 S Ste C, Brighton, TN 38011-8025 | 2010-05-25 |
| 1417026402 | Teresa H. Wallace | Speech-Language Pathologist | 1511 Copper Creek Dr, Owensboro, KY 42303-1797 | 2006-11-06 |
| 1154966984 | Teresa Michelle Wallace | Behavior Technician | 1941 S 42nd St Ste 328, Omaha, NE 68105-2943 | 2019-11-15 |
| 1497709703 | Teresa Wallace | Audiologist | 1700 S Lincoln Ave, Lebanon, PA 17042-7529 | 2006-05-20 |
| Street Address |
3915 TALBOT RD S STE 401 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588663173 | Howard Nicholas Straub | Ophthalmology | 3915 Talbot Rd S, Ste 310, Renton, WA 98055-5738 | 2005-07-18 |
| 1265098891 | Kendra Raquel Fitzpatrick | Nurse Practitioner | 3915 Talbot Rd S, Renton, WA 98055-5738 | 2019-05-20 |
| 1710458559 | Trevor Romo | Physician Assistant | 3915 Talbot Rd S, Renton, WA 98055-5738 | 2018-12-05 |
| 1801370697 | Caylin Hunter Cheney | Registered Nurse | 3915 Talbot Rd S, Suite 200, Renton, WA 98055 | 2018-09-18 |
| 1295226355 | Kristin June Braden Thai | Student in an Organized Health Care Education/Training Program | 3915 Talbot Rd S, Renton, WA 98055-5738 | 2018-05-24 |
| 1275989881 | Josh Huhndorf | Family Medicine | 3915 Talbot Rd S, Suite 401, Renton, WA 98055-5738 | 2016-05-12 |
| 1245686948 | Karena Lynn Whitworth | Family Medicine | 3915 Talbot Rd S, Suite 401, Renton, WA 98055-5738 | 2016-05-11 |
| 1932555620 | Erin Mclaughlin | Family Medicine | 3915 Talbot Rd S, Suite 401, Renton, WA 98055-5738 | 2016-05-11 |
| 1508212200 | Pnina Strasbourger | Family Medicine | 3915 Talbot Rd S, Suite 401, Renton, WA 98055-5738 | 2016-05-11 |
| 1225484926 | Garima Ajmani | Family Medicine | 3915 Talbot Rd S, Suite 401, Renton, WA 98055-5738 | 2016-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427672310 | Andrea Lauren Cistulli | Family Medicine | 3619 Talbot Rd S Ste 401, Renton, WA 98055-5708 | 2020-06-05 |
| 1639609803 | Kirsten Margaret Anderson | Family Medicine | 1205 N 10th St Ste 103-c, Renton, WA 98057-5577 | 2017-06-19 |
| 1366823742 | Timothy Asher | Family Medicine | 10555 Se Carr Rd # M, Renton, WA 98055-5820 | 2015-06-11 |
| 1508150152 | Kristin F Parker | Family Medicine | 3915 Talbot Rd S Ste 200, Renton, WA 98055-5738 | 2011-05-31 |
| 1124264577 | Kaiser Foundation Health Plan of Washington | Family Medicine | 2715 Naches Ave Sw, Gsw-a1n-02, Renton, WA 98057-2627 | 2009-01-06 |
| 1124204748 | Judith Lynn Molin | Family Medicine | Ne 8th Ave and Park Ave North, The Boeing Company, Renton, WA 98055 | 2008-01-14 |
| 1215012596 | William Zeev N Young | Family Medicine | 920 N 1st St, Renton, WA 98057-5759 | 2006-10-26 |
| 1285724831 | Paradigm Family Medicine Pllc | Family Medicine | 700 Sw 39th St, Suite 216, Renton, WA 98055-4952 | 2006-10-13 |
| 1568579092 | John K Mayeno | Family Medicine | 17900 Talbot Rd, S # 102, Renton, WA 98055 | 2006-08-23 |
| 1801817465 | Ronald Schubert | Family Medicine | 707 S Grady Way Ste 600, Renton, WA 98057-3227 | 2006-07-21 |
| Find all providers in RENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.