Renee T Tedder

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00009010 Issued in WA

Practice address

111 Market St NE
Suite 108
Olympia, WA 98501-1008

Phone

(360) 754-7085

Fax

(360) 754-3671

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 14

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1831279710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 CORPORATE CENTER LOOP SE",
            "address_2": "SUITE D",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035952",
            "telephone_number": "360-455-8155",
            "fax_number": "360-455-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARKET ST NE",
            "address_2": "SUITE 108",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011008",
            "telephone_number": "360-754-7085",
            "fax_number": "360-754-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDDER",
        "first_name": "RENEE",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "1192TE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "710883456-98516-A003",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "4939TE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "710883456-98503-A009",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "6544TE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "710883456-98501-A010",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8401820",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "710883456-98512-A008",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR & INDUSTRY",
            "identifier": "0219728",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "5691TE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "710883456-98502-A005",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7242925",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "8493TE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS",
            "identifier": "8944149",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Michael Teague, D.C.
• Anne Elizabeth Teater, CPM
• Molly Sue Tebay, LMHC
• Jeffrey S. Tebbs, DNP, PHD
• Scott L. Tebeau, P.T.
• Dean E Teehee Jr.
• Mark Douglas Teigen, D.D.S.
• April Telan
• Telecare Mental Health Services of Washington Inc
• Telecare Mental Health Services of Washington, Inc

• Physical Therapist in Olympia, WA
• Providers in Olympia, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.