Healthcare Provider Details

I. General information

NPI: 1740121201
Provider Name (Legal Business Name): TESSA EILEEN BOLCER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10733 VALLEY VIEW RD UNIT C301
BOTHELL WA
98011-3294
US

IV. Provider business mailing address

10733 VALLEY VIEW RD UNIT C301
BOTHELL WA
98011-3294
US

V. Phone/Fax

Practice location:
  • Phone: 941-725-9465
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.70113119-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: