Provider Demographics
NPI:1811776768
Name:DALE, JEFFRHEANA SHERREE
Entity type:Individual
Prefix:
First Name:JEFFRHEANA
Middle Name:SHERREE
Last Name:DALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RHEANA
Other - Middle Name:
Other - Last Name:DALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9551 RAINIER AVE S APT 108
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6048
Mailing Address - Country:US
Mailing Address - Phone:206-730-4023
Mailing Address - Fax:
Practice Address - Street 1:2133 3RD AVE STE 116
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2353
Practice Address - Country:US
Practice Address - Phone:206-432-3574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor