MEDICARE: OLIVER CECIL TRULOCK

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
1	106S00000X	Behavior Technician
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1831994250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVER CECIL TRULOCK

Provider Business Mailing Address
First Line	:	4526 FEDERAL AVE
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98203-2132
Country	:	US
Telephone Number	:	425-349-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	4350 CORDATA PKWY STE 230
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-8278
Country	:	US
Telephone Number	:	425-521-0000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	12/10/2025

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Directions to “ OLIVER CECIL TRULOCK ” Practice Location

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