Theodore Green
NPI #1053954776 in Tacoma, Washington
Provider Information
- NPI Number
- 1053954776
- Entity Type
- Individual
- Name
- Theodore Green
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Oct 25, 2019
- Last Updated
- Mar 18, 2021
Practice Location
- Address
- 3716 PACIFIC AVE STE E
- City
- Tacoma
- State
- Washington
- ZIP Code
- 98418-7836
- Phone
- (253) 474-5141
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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