Provider Demographics
NPI:1013275163
Name:TREICHEL, SHEVY L
Entity type:Individual
Prefix:
First Name:SHEVY
Middle Name:L
Last Name:TREICHEL
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 1:11155 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-5600
Mailing Address - Country:US
Mailing Address - Phone:713-474-4171
Mailing Address - Fax:713-747-4249
Practice Address - Street 1:9611 MICKELBERRY RD NW STE A
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8300
Practice Address - Country:US
Practice Address - Phone:360-633-2960
Practice Address - Fax:360-633-3159
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPS60607250224P00000X
TX1504222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist