Provider Demographics
NPI:1922575703
Name:WORRELL, DALE
Entity Type:Individual
Prefix:MR
First Name:DALE
Middle Name:
Last Name:WORRELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24316 89TH PL W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-9011
Mailing Address - Country:US
Mailing Address - Phone:425-672-8764
Mailing Address - Fax:
Practice Address - Street 1:CENTER FOR HUMAN SERVICES
Practice Address - Street 2:17018 15TH AVE NE
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155
Practice Address - Country:US
Practice Address - Phone:206-362-7282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health