Provider Demographics
NPI:1902372998
Name:NORTHWEST TELEPSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:NORTHWEST TELEPSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:TULK
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:360-780-3535
Mailing Address - Street 1:4152 MERIDIAN ST.
Mailing Address - Street 2:SUITE 105, #387
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226
Mailing Address - Country:US
Mailing Address - Phone:360-780-3535
Mailing Address - Fax:360-300-2495
Practice Address - Street 1:1151 ELLIS ST STE 206
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5245
Practice Address - Country:US
Practice Address - Phone:360-780-3535
Practice Address - Fax:360-300-2495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty