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1871509646
TERESA L WALLACE
RENTON, WA
NPI
1871509646
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WA MD00025633)
Enumeration Date
2006-07-31
Last Update Date
2012-09-17
Business Address
-- TERESA L WALLACE MD
3915 TALBOT RD S STE 401
RENTON, WA 98055-5738
Phone number: 425-656-4224
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Mailing Address
-- TERESA L WALLACE MD
3600 LIND AVE SW STE 100
RENTON, WA 98057-4934
Phone number: 425-656-5412
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