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NPI Code Detail

MEDICARE: TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING

MEDICARE: TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING
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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1578272712
Entity Type Code : Organization
Provider Name (Legal Business Name) : TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING
Provider Business Mailing Address
First Line : 6330 31ST AVE NE STE 101
Second Line :
City : TULALIP
State : WA
Zip : 98271-7423
Country : US
Telephone Number : 360-716-2200
Fax Number :
Provider Business Practice Location Address
First Line : 6330 31ST AVE NE STE 101
Second Line :
City : TULALIP
State : WA
Zip : 98271-7423
Country : US
Telephone Number : 360-716-2200
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : TANYA BURNS
Credential :
Telephone Number : 360-502-3117
Provider Enumeration Date : 11/16/2022
Last Update Date : 02/09/2023

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Directions to “TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING ” Practice Location

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