Provider Demographics
NPI:1710791041
Name:REPASZ, TEFFANIE LENE LLAMADA (ARNP)
Entity type:Individual
Prefix:MS
First Name:TEFFANIE LENE
Middle Name:LLAMADA
Last Name:REPASZ
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8908 BETHEL BURLEY RD SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-7815
Mailing Address - Country:US
Mailing Address - Phone:360-434-2146
Mailing Address - Fax:
Practice Address - Street 1:8908 BETHEL BURLEY RD SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367-7815
Practice Address - Country:US
Practice Address - Phone:360-434-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61639870363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily