Provider Demographics
NPI:1487243192
Name:NOEL, TERESA PATRICIA (CHHP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:PATRICIA
Last Name:NOEL
Suffix:
Gender:F
Credentials:CHHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7727 NE 201ST PL
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-2120
Mailing Address - Country:US
Mailing Address - Phone:425-686-0767
Mailing Address - Fax:
Practice Address - Street 1:12006 98TH AVE NE STE 103
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4218
Practice Address - Country:US
Practice Address - Phone:425-686-0767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty