MEDICARE: MS. TAMARA MARIE-SUE MATTSON LMHC

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	LH60233712	WA

General Provider Information

NPI Number	:	1639295710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAMARA MARIE-SUE MATTSON LMHC

Provider Business Mailing Address
First Line	:	2665 KWINA RD
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226
Country	:	US
Telephone Number	:	360-384-7131
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 N COMMERCIAL ST STE 2400
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-4446
Country	:	US
Telephone Number	:	360-734-0615
Fax Number	:	360-312-4218

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	11/19/2024

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