Theodore Basil Jerdes, LMP
Specialist · Lacey, WA
Practice location
1210 Sleater Kinney Rd SELacey, WA 98503-2316
- Phone
- (360) 352-4511
- Fax
- (360) 754-4703
NPI record
- NPI
- 1992251201
- Entity type
- Individual (Type 1)
- Enumeration date
- August 27, 2016
- Last updated
- August 27, 2016
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X |
MA 60597586 | WA |
About Theodore Jerdes
Theodore Basil Jerdes, LMP is a healthcare provider registered in the NPI registry with the primary taxonomy Specialist (code 174400000X). The practice location is 1210 Sleater Kinney Rd SE, Lacey, WA 98503-2316. The NPI number 1992251201 was assigned on August 27, 2016 and the record was last updated on August 27, 2016.
Theodore Jerdes lists a license in the registry: #MA 60597586 (WA) for Specialist. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Theodore Basil Jerdes, LMP?
The NPI number is 1992251201.
What is the phone number of Theodore Jerdes?
The phone number listed for the practice location is (360) 352-4511.
Where is Theodore Jerdes located?
1210 Sleater Kinney Rd SE, Lacey, WA 98503-2316.
What is the taxonomy code for Theodore Jerdes?
The primary taxonomy code is 174400000X – Specialist.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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