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Active NPI 1992251201 Individual Practitioner Male Practitioner

Theodore Basil Jerdes , LMP

Specialist • Lacey, WA

Professional Overview & Biography Verified Profile Summary

Theodore Jerdes, LMP is a registered healthcare professional specializing in Specialist in Lacey, WA. Practice services are available at 1210 SLEATER KINNEY RD SE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1210 Sleater Kinney Rd Se

Lacey, WA 985032316

Telephone 3603524511
Fax 3607544703
Associated Practice Facility / Clinic
🏢 Elaine Vaughn Counseling Llc Facility NPI 1780403097

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Lacey, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 35.4 Yrs
Regional Practice Density
35 Specialists

Practicing in Lacey, WA (2751 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License WA MA 60597586

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Emily Gibbs , LMT

Massage Therapist

NPI 1083106264

Licensed Massage Therapist

Emily Treakle-Chase , LMT

Massage Therapist

NPI 1154438687

Licensed Massage Therapist

NPI 1164656203

Licensed Massage Practitioner

Jennifer Slocum

Massage Therapist

NPI 1508277880
James Dinsmore , LMT

Massage Therapist

NPI 1518237296

Licensed Massage Therapist

Joanne Archer

Specialist

NPI 1558543579

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 27, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location August 27, 2016

Registered at 1210 SLEATER KINNEY RD SE, LACEY, WA 985032316 (Tel: 3603524511)

📍
Updated Business Mailing Address August 27, 2016

Registered at 1210 SLEATER KINNEY RD SE, LACEY, WA 985032316 (Tel: 3603524511)

👤
Provider Name / Credentials Updated August 27, 2016

Recorded as THEODORE JERDES, LMP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 27, 2016

Specialist (License #MA 60597586 in WA)

🟢
Initial NPI Registration & Enumeration August 27, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992251201
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 27, 2016
Last Update: August 27, 2016
Sole Proprietor: No

Mailing Address

1210 Sleater Kinney Rd Se

Lacey, WA 985032316

Phone: 3603524511

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.