Healthcare Provider Details

I. General information

NPI: 1881589018
Provider Name (Legal Business Name): YSABEL REOUX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8811 S TACOMA WAY UNIT 204206
LAKEWOOD WA
98499-4595
US

IV. Provider business mailing address

4608 76TH AVENUE CT W # I8
UNIVERSITY PLACE WA
98466-3760
US

V. Phone/Fax

Practice location:
  • Phone: 253-321-1955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: