Healthcare Provider Details

I. General information

NPI: 1740935113
Provider Name (Legal Business Name): HELENA THIEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 STEWART ST STE 300
SEATTLE WA
98101-1257
US

IV. Provider business mailing address

22415 SE 231ST ST STE B103
MAPLE VALLEY WA
98038-5002
US

V. Phone/Fax

Practice location:
  • Phone: 480-703-4398
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberAB61615713
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: