Provider Demographics
NPI:1528241411
Name:HALL, TRESSA SHELISH (BACHELORS)
Entity type:Individual
Prefix:
First Name:TRESSA
Middle Name:SHELISH
Last Name:HALL
Suffix:
Gender:F
Credentials:BACHELORS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 S M ST APT 101
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3571
Mailing Address - Country:US
Mailing Address - Phone:253-396-5922
Mailing Address - Fax:
Practice Address - Street 1:3834 S 19TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2016
Practice Address - Country:US
Practice Address - Phone:253-396-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00059798OtherWA DEPT. OF HEALTH