Provider Demographics
NPI:1598654659
Name:STARR, TERESA M (HCW)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:M
Last Name:STARR
Suffix:
Gender:F
Credentials:HCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 SW 5TH AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-4003
Mailing Address - Country:US
Mailing Address - Phone:971-320-9966
Mailing Address - Fax:
Practice Address - Street 1:429 SW 5TH AVE
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-4003
Practice Address - Country:US
Practice Address - Phone:971-320-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR668718374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty