MS. THERESA WIEDERHOLD (NPI# 1255325460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255325460 |
| Entity Type | Individual |
| Full Name | MS. THERESA WIEDERHOLD |
| Credential | ARNP |
| Practice Address |
5921 N Market St Spokane WA 99208-2484 |
| Mailing Address |
203 N Washington St Ste 300 Spokane WA 99201-0233 |
| Practice Telephone | 5094871604 |
| Practice Fax Number | 5094826286 |
| Mailing Telephone | 5094448888 |
| Mailing Fax Number | 5094447806 |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2012-01-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP30006019 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5921 N MARKET ST |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-2484 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316581465 | Community Health Association of Spokane | Pharmacy | 5921 N Market St, Spokane, WA 99208-2484 | 2019-11-01 |
| 1528526993 | Ryan Michael Lysne | Physician Assistant | 5921 N Market St, Spokane, WA 99208-2484 | 2019-03-05 |
| 1518475961 | Jennifer Patricia Loweree | Dietitian, Registered | 5921 N Market St, Spokane, WA 99208-2484 | 2018-01-19 |
| 1316478183 | Lich Pham | Family Medicine | 5921 N Market St, Spokane, WA 99208-2484 | 2017-03-23 |
| 1245773571 | Caitlin Miller | Physician Assistant | 5921 N Market St, Spokane, WA 99208 | 2016-11-17 |
| 1114476439 | Tamara Ganahl | Nurse Practitioner | 5921 N Market St, Spokane, WA 99208-2484 | 2016-09-28 |
| 1003218389 | Jeffrey Hayward | Physician Assistant | 5921 N Market St, Spokane, WA 99208-2484 | 2014-09-18 |
| 1942620307 | Joshua Raymond Kistner | Family Medicine | 5921 N Market St, Spokane, WA 99208 | 2014-04-23 |
| 1477828556 | Brian Mizoguchi | Counselor | 5921 N Market St, Spokane, WA 99208-2484 | 2012-03-21 |
| 1477856144 | Community Health Association of Spokane | Pharmacy | 5921 N Market St, Spokane, WA 99208-2484 | 2010-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609330992 | Bryan Donald Cress | Nurse Practitioner | 9425 N Nevada St Ste 300, Spokane, WA 99218-1286 | 2019-01-30 |
| 1922570373 | Cassandra Lynn Prewitt | Nurse Practitioner | 400 E 5th Ave # 1, Spokane, WA 99202-1334 | 2018-12-26 |
| 1447743117 | Matthew Kilgore | Nurse Practitioner | 707 W 7th Ave Ste 290, Spokane, WA 99204-2833 | 2018-06-07 |
| 1902252505 | Richard D Ervin | Nurse Practitioner | 1820 W Pepper Ln, Spokane, WA 99218-2759 | 2016-05-12 |
| 1396118469 | Kerry Lee Traugott | Nurse Practitioner | 2405 E 17th Ave, Suite 113, Spokane, WA 99223 | 2015-11-11 |
| 1427427178 | Kristen Bolling | Nurse Practitioner | 6518 E Lyons Ave, Spokane, WA 99217-9700 | 2015-09-23 |
| 1063897965 | Julia Wolf | Nurse Practitioner | 9631 N Nevada St Ste 202, Spokane, WA 99218-1197 | 2015-07-21 |
| 1457746737 | Ashley Jones | Nurse Practitioner | 10414 W Highway 2 Ste 10, Spokane, WA 99224-5347 | 2015-04-02 |
| 1639580111 | Avante Human Services and Advocacy Project LLC | Nurse Practitioner | 1312 N Monroe St Ste 305, Spokane, WA 99201-2623 | 2014-05-18 |
| 1518387067 | Jennifer Lyn Nava | Nurse Practitioner | 316 W Boone Ave Ste 757, Spokane, WA 99201-2364 | 2014-04-23 |
| Find all providers in SPOKANE | ||||
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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.