Provider Demographics
NPI:1942997861
Name:FIELDS, TA'RYTA D
Entity type:Individual
Prefix:MS
First Name:TA'RYTA
Middle Name:D
Last Name:FIELDS
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 1:750 S 216TH ST APT 36
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6327
Mailing Address - Country:US
Mailing Address - Phone:206-379-0364
Mailing Address - Fax:
Practice Address - Street 1:851 POPLAR PL S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2827
Practice Address - Country:US
Practice Address - Phone:206-379-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health