Provider Demographics
NPI:1922327691
Name:WADE, TREASURE (BA)
Entity Type:Individual
Prefix:
First Name:TREASURE
Middle Name:
Last Name:WADE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:TREASURE
Other - Middle Name:
Other - Last Name:SATCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX 271690
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-5035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1406 CENTAUR CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-1432
Practice Address - Country:US
Practice Address - Phone:720-837-2348
Practice Address - Fax:303-554-5657
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist