person
Mr. Theodore Basil Jerdes, LMP
Specialist in Lacey, Washington
NPI 1992251201

Theodore Basil Jerdes is a Specialist based in Lacey, WA. Theodore Basil Jerdes practices in Lacey, WA and has the professional credentials of LMP. The NPI Number for Theodore Basil Jerdes is 1992251201 and holds a License No. MA 60597586 (Washington).

The current practice location address for Theodore Basil Jerdes is 1210 Sleater Kinney Rd Se, Lacey, WA and can be reached out via phone at 360-352-4511 and via fax at 360-754-4703. You can also correspond with Theodore Basil Jerdes through the mailing address at 1210 SLEATER KINNEY RD SE, LACEY, WA - 98503-2316 (mailing address contact number: 360-352-4511).

Location: 1210 Sleater Kinney Rd Se, Lacey, WA, 98503-2316
person
Provider Profile Details
NPI Number
1992251201
Provider Name
Theodore Basil Jerdes
Credential
LMP
Provider Entity Type
Individual
Gender
Male
Address
1210 Sleater Kinney Rd Se, Lacey, WA, 98503-2316
Phone Number
360-352-4511
Fax Number
360-754-4703
Provider Enumeration Date
08/27/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1210 Sleater Kinney Rd Se
City
State
Zip
98503-2316
Phone Number
360-352-4511
Fax Number
360-754-4703
person
Provider Business Mailing Address Details
Address
1210 Sleater Kinney Rd Se
City
State
Zip
98503-2316
Phone Number
360-352-4511
Fax Number
360-754-4703
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
MA 60597586 (Washington)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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