Provider Demographics
NPI:1124042544
Name:TREBILCOCK, THERESA M (RDMS, RDCS)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:M
Last Name:TREBILCOCK
Suffix:
Gender:F
Credentials:RDMS, RDCS
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Mailing Address - Street 1:11012 CANYON RD E
Mailing Address - Street 2:STE 8
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-4200
Mailing Address - Country:US
Mailing Address - Phone:253-921-6613
Mailing Address - Fax:253-435-1933
Practice Address - Street 1:11012 CANYON RD E
Practice Address - Street 2:STE 8
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-4200
Practice Address - Country:US
Practice Address - Phone:253-921-6613
Practice Address - Fax:253-435-1933
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA196832471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography