Provider Demographics
NPI:1518843432
Name:SOULE, RENEE GWENDOLYN (PHD)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:GWENDOLYN
Last Name:SOULE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 HAPPY CT
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7529
Mailing Address - Country:US
Mailing Address - Phone:510-558-8238
Mailing Address - Fax:
Practice Address - Street 1:1106 HARRIS AVE STE 301
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7002
Practice Address - Country:US
Practice Address - Phone:360-200-8737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61645003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health