Healthcare Provider Details

I. General information

NPI: 1619881810
Provider Name (Legal Business Name): MARYSA JOY SYLVESTER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7607 TOTEM BEACH RD
TULALIP WA
98271-6105
US

IV. Provider business mailing address

7607 TOTEM BEACH RD
TULALIP WA
98271-6105
US

V. Phone/Fax

Practice location:
  • Phone: 360-716-4250
  • Fax:
Mailing address:
  • Phone: 360-716-4250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC.LH.70114776
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: