Provider Demographics
NPI:1528407111
Name:TULK, MICHELE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:TULK
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:360-603-6386
Mailing Address - Fax:
Practice Address - Street 1:114 W MAGNOLIA ST STE 505
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4369
Practice Address - Country:US
Practice Address - Phone:360-603-6386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401598363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health