Provider Demographics
NPI:1043809981
Name:WINCHELL, RHONDA RAE
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:RAE
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 YAKIMA AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-5647
Mailing Address - Country:US
Mailing Address - Phone:253-230-6346
Mailing Address - Fax:
Practice Address - Street 1:4501 6TH AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-3503
Practice Address - Country:US
Practice Address - Phone:833-971-1230
Practice Address - Fax:253-292-1355
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACB61097664106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician