Theresa Wiederhold, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30006019 Issued in WA

Practice address

5921 N Market St
Spokane, WA 99208-2484

Phone

(509) 487-1604

Fax

(509) 482-6286

NPI assigned

Sep 1, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Columbia Medical Associates LLC

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1154414761
  NPD (past)
• Gordon Physical Therapy, PLLC

  • Physical Therapist
  • Spokane Valley, WA
  • NPI 1265585335
  NPD (past)
• Physicians Clinic of Spokane PS

  • Multi-Specialty Clinic/Center
  • Spokane, WA
  • NPI 1336186105
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1255325460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N WASHINGTON ST STE 300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010233",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 N MARKET ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992082484",
            "telephone_number": "509-487-1604",
            "fax_number": "509-482-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDERHOLD",
        "first_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30006019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason T Wicklund, PHARMD
• Nancy Ellen Wickre, ARNP
• Christina Mae Widdicombe
• Stephanie Widhalm, LICSW
• Candy L Widmer, LMP
• Kelly A Wiegardt, MA, CCC-SLP
• Allen Jason Wiemer, CRNA
• Eric Andrew Wien, MD
• Elenor Ann Wiens
• Nathan Jacob Wiens, PA-C

• Family Nurse Practitioner in Spokane, WA
• Providers in Spokane, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.