Provider Demographics
NPI:1366978215
Name:NOBLE, CHELSEA JILLIAN
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:JILLIAN
Last Name:NOBLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7075 NE BAY HILL RD
Mailing Address - Street 2:COTTAGE C
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-4294
Mailing Address - Country:US
Mailing Address - Phone:951-743-8094
Mailing Address - Fax:
Practice Address - Street 1:2414 SW ANDOVER ST
Practice Address - Street 2:D-120
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-1153
Practice Address - Country:US
Practice Address - Phone:425-563-1093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60759699103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst