Provider Demographics
NPI:1861782682
Name:MAJESKY, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:MAJESKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 132ND ST SE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8999
Mailing Address - Country:US
Mailing Address - Phone:425-357-9380
Mailing Address - Fax:425-357-9382
Practice Address - Street 1:403 W STANLEY ST
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:WA
Practice Address - Zip Code:98252-8631
Practice Address - Country:US
Practice Address - Phone:360-691-4835
Practice Address - Fax:360-691-2545
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0278360OtherL&I
WA0278304OtherL&I
WA0278307OtherL&I
WA0278365OtherL&I
WA0278360OtherL&I
WAG8900414Medicare PIN
WAG8900413Medicare PIN
WAG8904936Medicare PIN
WAG8900313Medicare PIN