Provider Demographics
NPI:1265905368
Name:HULTMAN, NATALIE ANN (AGENCY AFFILIATED CO)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:HULTMAN
Suffix:
Gender:F
Credentials:AGENCY AFFILIATED CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COLUMBIA WELLNESS
Mailing Address - Street 2:PO BOX 1847
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632
Mailing Address - Country:US
Mailing Address - Phone:360-353-9369
Mailing Address - Fax:360-577-0187
Practice Address - Street 1:2700 SIMPSON AVE
Practice Address - Street 2:STE 101
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520
Practice Address - Country:US
Practice Address - Phone:360-612-0012
Practice Address - Fax:360-532-0670
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG50501871175T00000X
WACAAR.CG.60602982101YM0800X
WA175T00000X
WACO61046812101YA0400X
WACG60602982101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No175T00000XOther Service ProvidersPeer Specialist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)