Individual provider Active NPI

Teresa Diane Harberg, RPH

  • Pharmacist
  • Federal Way, WA
National Provider Identifier
1710027503
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00015347 Issued in WA
Practice address
34509 9TH Ave S Ste 308
Federal Way, WA 98003-8710
Phone
(253) 944-6985
Fax
(253) 944-7585
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00015347 WA Primary

Addresses

Primary practice location

34509 9TH Ave S Ste 308
Federal Way, WA 98003-8710

Mailing address

35400 18TH Ave SW
Federal Way, WA 98023-6908
Phone (253) 235-5015

Other names 1

  • Teresa Diane Blanc Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH00015347WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Health System Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1710027503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35400 18TH AVE SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980236908",
            "telephone_number": "253-235-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34509 9TH AVE S STE 308",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038710",
            "telephone_number": "253-944-6985",
            "fax_number": "253-944-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBERG",
        "first_name": "TERESA",
        "middle_name": "DIANE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00015347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "BLANC",
            "middle_name": "DIANE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.