Provider Demographics
NPI:1962991265
Name:NADELA, LOUELLE
Entity type:Individual
Prefix:
First Name:LOUELLE
Middle Name:
Last Name:NADELA
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 1:15428 SE 252ND PL
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4192
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 2ND ST SW STE 140
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-5203
Practice Address - Country:US
Practice Address - Phone:206-480-6344
Practice Address - Fax:253-216-2821
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARBT-16-25872106S00000X
WA1-18-31987103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician