Provider Demographics
NPI:1811719065
Name:DEL REAL, TANIA GUADALUPE
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:GUADALUPE
Last Name:DEL REAL
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 1:338 NW 85TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3120
Mailing Address - Country:US
Mailing Address - Phone:206-659-5945
Mailing Address - Fax:
Practice Address - Street 1:338 NW 85TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3120
Practice Address - Country:US
Practice Address - Phone:206-659-5945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist