Healthcare Provider Details

I. General information

NPI: 1730627324
Provider Name (Legal Business Name): DANELLA FRERICHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 FAWCETT AVE
TACOMA WA
98402-5503
US

IV. Provider business mailing address

2602 WESTRIDGE AVE W APT M301
TACOMA WA
98466-8261
US

V. Phone/Fax

Practice location:
  • Phone: 253-386-5800
  • Fax:
Mailing address:
  • Phone: 360-689-3532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: