Provider Demographics
NPI:1225793623
Name:MAYFIELD, SUHEI DELILAH
Entity Type:Individual
Prefix:
First Name:SUHEI
Middle Name:DELILAH
Last Name:MAYFIELD
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 1:1916 NE 24TH ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-2259
Mailing Address - Country:US
Mailing Address - Phone:425-499-8571
Mailing Address - Fax:
Practice Address - Street 1:1025 ATLANTIC AVE
Practice Address - Street 2:#101
Practice Address - City:ALMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501
Practice Address - Country:US
Practice Address - Phone:510-268-8120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171R00000XOther Service ProvidersInterpreter