Healthcare Provider Details

I. General information

NPI: 1962991265
Provider Name (Legal Business Name): LOUELLE NADELA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 2ND ST SW STE 140
AUBURN WA
98001-5203
US

IV. Provider business mailing address

15428 SE 252ND PL
COVINGTON WA
98042-4192
US

V. Phone/Fax

Practice location:
  • Phone: 206-480-6344
  • Fax: 253-216-2821
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-31987
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-16-25872
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: