Provider Demographics
NPI:1841604592
Name:NOBLE, EVONNE
Entity Type:Individual
Prefix:
First Name:EVONNE
Middle Name:
Last Name:NOBLE
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 1:811 YAKIMA AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-3144
Mailing Address - Country:US
Mailing Address - Phone:206-324-3912
Mailing Address - Fax:206-569-0010
Practice Address - Street 1:2719 E MADISON ST
Practice Address - Street 2:STE 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4752
Practice Address - Country:US
Practice Address - Phone:206-324-3912
Practice Address - Fax:206-569-0010
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health