MEDICARE: CULTIVATE NW PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist
3	101Y00000X	Counselor

General Provider Information

NPI Number	:	1427902808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CULTIVATE NW PLLC

Provider Business Mailing Address
First Line	:	18220 BALLINGER WAY NE
Second Line	:
City	:	LAKE FOREST PARK
State	:	WA
Zip	:	98155-4237
Country	:	US
Telephone Number	:	425-417-8075
Fax Number	:

Provider Business Practice Location Address
First Line	:	18220 BALLINGER WAY NE
Second Line	:
City	:	LAKE FOREST PARK
State	:	WA
Zip	:	98155-4237
Country	:	US
Telephone Number	:	425-417-8075
Fax Number	:

Authorized Official
Title or Position	:	MARRIAGE & FAMILY THERAPIST ASSOC.
Name	:	MARCUS COMER
Credential	:	LMFTA
Telephone Number	:	425-417-8075

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	02/23/2026

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