Individual provider Active NPI

Teresa A. Wolber, ARNP

  • Family Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1942299052
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30000199 Issued in WA
Practice address
10416 5TH Ave NE
Seattle, WA 98125-7402
Phone
(206) 517-6700
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30000199 WA Primary

Addresses

Primary practice location

10416 5TH Ave NE
Seattle, WA 98125-7402

Mailing address

10416 5TH Ave NE
Seattle, WA 98125-7402
Phone (206) 517-6700

Other identifiers 1

IdentifierTypeStateIssuer
9601139MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address twolber1043653@wm.providencedirect.org
Direct Messaging Address twolber1043653@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics Current Accepting new patients
Pacmed Clinics CurrentSince Apr 1, 2003 Accepting new patients
Pacmed Clinics CurrentSince Apr 1, 2003 Accepting new patients
Pacmed Clinics Past Accepting new patients

Locations

1909 214th St SE
Ste 300
Bothell, WA 98021
Phone (425) 412-6335

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

10416 5th Ave NE
Seattle, WA 98125
Phone (206) 517-6667

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

Interoperability endpoints

  • Direct secure messaging: twolber1043653@wm.providencedirect.org

Organizations & group practices 4

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1942299052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10416 5TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257402",
            "telephone_number": "206-517-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10416 5TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257402",
            "telephone_number": "206-517-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLBER",
        "first_name": "TERESA",
        "middle_name": "A.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30000199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9601139",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twolber1043653@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "10416 5th Ave NE",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981257402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twolber1043653@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1909 214th St SE Ste 300",
            "city": "Bothell",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980214418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.