MEDICARE: TIMOTHY EILERS CDMS

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	101Y00000X	Counselor		WA

General Provider Information

NPI Number	:	1013681642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY EILERS CDMS

Provider Business Mailing Address
First Line	:	1810 E COLLEGE WAY STE 132
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-2362
Country	:	US
Telephone Number	:	360-428-3066
Fax Number	:	866-576-2195

Provider Business Practice Location Address
First Line	:	1810 E COLLEGE WAY STE 132
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-2362
Country	:	US
Telephone Number	:	360-428-3066
Fax Number	:	866-576-2195

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

Provider Enumeration Date	:	08/06/2021
Last Update Date	:	08/06/2021

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Directions to “ TIMOTHY EILERS CDMS” Practice Location

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