Provider Demographics
NPI:1609597277
Name:PLUM WELLNESS COLLECTIVE PLLC
Entity Type:Organization
Organization Name:PLUM WELLNESS COLLECTIVE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DORCAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:360-763-0336
Mailing Address - Street 1:115 W MAGNOLIA ST STE 209
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4300
Mailing Address - Country:US
Mailing Address - Phone:360-763-0336
Mailing Address - Fax:360-215-8981
Practice Address - Street 1:115 W MAGNOLIA ST STE 209
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4300
Practice Address - Country:US
Practice Address - Phone:360-763-0336
Practice Address - Fax:360-215-8981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA271965109Medicaid