Provider Demographics
NPI:1770359192
Name:ZEH-RAHK, DEIDRE D
Entity type:Individual
Prefix:
First Name:DEIDRE
Middle Name:D
Last Name:ZEH-RAHK
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 1:16800 27TH AVE NE APT L255
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98271-1328
Mailing Address - Country:US
Mailing Address - Phone:425-404-9186
Mailing Address - Fax:
Practice Address - Street 1:16800 27TH AVE NE APT L255
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-1328
Practice Address - Country:US
Practice Address - Phone:425-404-9186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician