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NPI Code Detail

MEDICARE: JAMES TUTTLE

MEDICARE: JAMES TUTTLE
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCP00000291WA
2101Y00000XCounselorCQ61663068WA

General Provider Information

NPI Number : 1104950351
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES TUTTLE
Provider Business Mailing Address
First Line : PO BOX 959
Second Line :
City : YAKIMA
State : WA
Zip : 98907-0959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 609 SPEYERS RD
Second Line :
City : SELAH
State : WA
Zip : 98942-1050
Country : US
Telephone Number : 509-225-6311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 04/09/2025

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