Healthcare Provider Details

I. General information

NPI: 1013626217
Provider Name (Legal Business Name): MAX TUVLOFF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 JAMES ST
SEATTLE WA
98104-5102
US

IV. Provider business mailing address

216 JAMES ST
SEATTLE WA
98104-5102
US

V. Phone/Fax

Practice location:
  • Phone: 206-464-6454
  • Fax: 206-652-1236
Mailing address:
  • Phone: 206-464-6454
  • Fax: 206-652-1236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN60974512
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60974512
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: