Provider Demographics
NPI:1174236517
Name:REZENE, TEAME
Entity type:Individual
Prefix:
First Name:TEAME
Middle Name:
Last Name:REZENE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12047 69TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-4124
Mailing Address - Country:US
Mailing Address - Phone:206-518-7793
Mailing Address - Fax:
Practice Address - Street 1:12047 69TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-4124
Practice Address - Country:US
Practice Address - Phone:206-518-7793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator