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NPI Code Detail

MEDICARE: NATHAN TOLLEY DO

MEDICARE: NATHAN TOLLEY DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician0061698CO
22084P0800XPsychiatry PhysicianOP61220523WA

General Provider Information

NPI Number : 1235666389
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN TOLLEY DO
Provider Business Mailing Address
First Line : 901 S 5TH ST
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98274-3942
Country : US
Telephone Number : 360-814-7300
Fax Number : 360-848-4543
Provider Business Practice Location Address
First Line : 901 S 5TH ST
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98274-3942
Country : US
Telephone Number : 360-814-7300
Fax Number : 360-848-4543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2017
Last Update Date : 12/10/2025

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Directions to “ NATHAN TOLLEY DO” Practice Location

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