Provider Demographics
NPI:1699356683
Name:TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING
Entity Type:Organization
Organization Name:TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING
Other - Org Name:QUIL CEDA CREEK COUNSELING COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-716-2200
Mailing Address - Street 1:6330 31ST AVE NE STE 101
Mailing Address - Street 2:
Mailing Address - City:TULALIP
Mailing Address - State:WA
Mailing Address - Zip Code:98271-7423
Mailing Address - Country:US
Mailing Address - Phone:360-716-2200
Mailing Address - Fax:360-716-2211
Practice Address - Street 1:6330 31ST AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:TULALIP
Practice Address - State:WA
Practice Address - Zip Code:98271-7423
Practice Address - Country:US
Practice Address - Phone:360-716-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TULALIP TRIBES OF WASHINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-20
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility