Healthcare Provider Details

I. General information

NPI: 1689677114
Provider Name (Legal Business Name): CRAIG STULL MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 10TH AVE E STE 7
SEATTLE WA
98102-4377
US

IV. Provider business mailing address

2628 MARINE AVE SW
SEATTLE WA
98116-2816
US

V. Phone/Fax

Practice location:
  • Phone: 206-329-1660
  • Fax:
Mailing address:
  • Phone: 206-329-1660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP00003175
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00003470
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: