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NPI Code Detail

MEDICARE: TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING

MEDICARE: TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING
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
12083P0901XPublic Health & General Preventive Medicine Physician
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
4324500000XSubstance Abuse Rehabilitation Facility
5261QM2800XMethadone Clinic

General Provider Information

NPI Number : 1699356683
Entity Type Code : Organization
Provider Name (Legal Business Name) : TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING
Provider Business Mailing Address
First Line : 6330 31ST AVE NE STE 101
Second Line :
City : TULALIP
State : WA
Zip : 98271-7423
Country : US
Telephone Number : 360-716-2200
Fax Number : 360-716-2211
Provider Business Practice Location Address
First Line : 6330 31ST AVE NE STE 101
Second Line :
City : TULALIP
State : WA
Zip : 98271-7423
Country : US
Telephone Number : 360-716-2200
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : TANYA BURNS
Credential :
Telephone Number : 360-716-2200
Provider Enumeration Date : 04/20/2021
Last Update Date : 02/21/2023

Similar Medicare Providers

1285661744 — ALESSA L LOPEZ-CASTOR FNP-C
Practice Location Address:
6330 31ST AVE NE STE 101
TULALIP, WA
98271-7423
Practice Phone: 360-716-2200
Practice Fax: 360-716-2211
1710396387 — REBECCA EPPERSON ARNP
Practice Location Address:
6330 31ST AVE NE STE 101
TULALIP, WA
98271-7423
Practice Phone: 360-716-2200
Practice Fax:
1689232639 — ELISSA CHARLENE JULES CP61224601
Practice Location Address:
6330 31ST AVE NE STE 101
TULALIP, WA
98271-7423
Practice Phone: 360-716-2200
Practice Fax: 360-716-2211
1326661752 — RYAN CUDDY CO 61009527
Practice Location Address:
6330 31ST AVE NE STE 101
TULALIP, WA
98271-7423
Practice Phone: 360-716-2200
Practice Fax:
1578272712 — TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING
Practice Location Address:
6330 31ST AVE NE STE 101
TULALIP, WA
98271-7423
Practice Phone: 360-716-2200
Practice Fax:
1033004619 — JAMIE LYNN ADAMS SUDP
Practice Location Address:
6330 31ST AVE NE STE 191
TULALIP, WA
98271-7423
Practice Phone: 360-716-2200
Practice Fax:

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