Provider Demographics
NPI:1114402310
Name:TREMBLY, TAYLOR NOELLE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NOELLE
Last Name:TREMBLY
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 1:5126 SW 327TH PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-1942
Mailing Address - Country:US
Mailing Address - Phone:253-347-4867
Mailing Address - Fax:
Practice Address - Street 1:1800 112TH AVE NE STE 260E
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2937
Practice Address - Country:US
Practice Address - Phone:425-643-2133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst