Provider Demographics
NPI:1700823341
Name:BUELL, NOELLE CHRISTINE (BS,MS,PT)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:CHRISTINE
Last Name:BUELL
Suffix:
Gender:F
Credentials:BS,MS,PT
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:CHRISTINE
Other - Last Name:DRAGGOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS,MS,PT
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-0047
Mailing Address - Country:US
Mailing Address - Phone:253-697-2065
Mailing Address - Fax:
Practice Address - Street 1:407 14TH AVE SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-0047
Practice Address - Country:US
Practice Address - Phone:253-697-2065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9605BUOtherREGENCE
WA8930574OtherL&I CRIME VICTIM PRGM
WA8384794Medicaid
WA181548OtherLABOR & INDUSTRIES
WAP00286530Medicare ID - Type UnspecifiedRAILROAD MEDICARE
WA8802109Medicare ID - Type Unspecified