Theodore Basil Jerdes, LMP

Specialist · Lacey, WA

Individual Active NPI

NPI number 1992251201

Practice location

1210 Sleater Kinney Rd SE
Lacey, WA 98503-2316
Phone
(360) 352-4511
Fax
(360) 754-4703

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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

TaxonomyCodeLicenseState
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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