| Doctor Name: | TRACEY MARIE WENTHIN |
| NPI Number: | 1245666551 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CG |
| License Number: | CG60409010 |
| Business Practice Address: | 105 Nw 1st St Coupeville, WA - 982393138 |
| Business Phone Number: | 3606785555 |
| Business Fax Number: | 6306783636 |
| Mailing Address: | Po Box 3810, EVERETT |
| State: | WA |
| Postal Code: | 982138810 |
| Phone Number: | 3606785555 |
| Fax Number: | 3606783636 |
| NPI Enumeration Date: | 09/18/2013 |
| NPI Last Update Date: | 09/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | CG60409010 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |