MEDICARE: DR TIFFANY WASHA COUNSELING LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1093512089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR TIFFANY WASHA COUNSELING LLC

Provider Business Mailing Address
First Line	:	338 SW JUDSON DR
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-5801
Country	:	US
Telephone Number	:	360-441-9515
Fax Number	:

Provider Business Practice Location Address
First Line	:	338 SW JUDSON DR
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-5801
Country	:	US
Telephone Number	:	360-441-9515
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	SHERRI LEWIS
Credential	:
Telephone Number	:	360-441-9515

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	01/14/2026

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