THEODORE GREEN

TACOMA, WA
NPI1053954776
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: WA  AP61015452)
Enumeration Date2019-10-25
Last Update Date2021-03-18
Business Address
THEODORE GREEN
3716 PACIFIC AVE STE E
TACOMA, WA 98418-7836
Phone number: 253-474-5141
Mailing Address
THEODORE GREEN
3716 PACIFIC AVE STE E
TACOMA, WA 98418-7836
Phone number: 253-474-5141
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