Provider Demographics
NPI:1689483760
Name:NOUAILLE, CECILE
Entity type:Individual
Prefix:
First Name:CECILE
Middle Name:
Last Name:NOUAILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CECILE
Other - Middle Name:
Other - Last Name:LAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12062 NE 137TH CT
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2122
Mailing Address - Country:US
Mailing Address - Phone:661-220-0195
Mailing Address - Fax:
Practice Address - Street 1:6201 PACIFIC AVE STE C3
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-7423
Practice Address - Country:US
Practice Address - Phone:253-363-8853
Practice Address - Fax:253-292-1919
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health