Stephen Mark Tetrick

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN61064904 Issued in WA

Practice address

2600 SW Holden St
Seattle, WA 98126-3505

Phone

(206) 933-7000

NPI assigned

Aug 10, 2022

Sex

Male

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1508594243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 FIR ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898013024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SW HOLDEN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263505",
            "telephone_number": "206-933-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETRICK",
        "first_name": "STEPHEN",
        "middle_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61064904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samone Tessmer
• Matthew Ryan Test, M.D.
• Dakota Layne Teterud
• Mary Elizabeth Tetrault
• Timothy Lance Tetrault, LMHC
• Monique Lynn Tetzloff, MS, MHP, LMFT
• Sela Teulilo
• Monica Teuthorn
• Melissa Teuton, REGISTERED NURSE
• Meagan Elizabeth Teutsch, LICSW

• Registered Nurse in Seattle, WA
• Providers in Seattle, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.