Theresa M Trebilcock, RDMS, RDCS

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

19683 Issued in WA

Practice address

11012 Canyon Rd E
Ste 8
Puyallup, WA 98373-4200

Phone

(253) 921-6613

Fax

(253) 435-1933

NPI assigned

Jul 27, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124042544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11012 CANYON RD E",
            "address_2": "STE 8",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734200",
            "telephone_number": "253-921-6613",
            "fax_number": "253-435-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11012 CANYON RD E",
            "address_2": "STE 8",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734200",
            "telephone_number": "253-921-6613",
            "fax_number": "253-435-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREBILCOCK",
        "first_name": "THERESA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "RDMS, RDCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "WA",
            "license": "19683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sonography Radiologic Technologist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Sonography Radiologic Technologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.