Provider Demographics
NPI:1104534718
Name:TACHELL, GAYLE (MA LMHCA)
Entity type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:
Last Name:TACHELL
Suffix:
Gender:F
Credentials:MA LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 165TH PL SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8004
Mailing Address - Country:US
Mailing Address - Phone:425-319-4838
Mailing Address - Fax:
Practice Address - Street 1:3205 165TH PL SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-8004
Practice Address - Country:US
Practice Address - Phone:425-319-4838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604984476-001-0001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMC61373082OtherCOUNSELING