Provider Demographics
NPI:1013681642
Name:EILERS, TIMOTHY (CDMS)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:EILERS
Suffix:
Gender:M
Credentials:CDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 E COLLEGE WAY STE 132
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2362
Mailing Address - Country:US
Mailing Address - Phone:360-428-3066
Mailing Address - Fax:866-576-2195
Practice Address - Street 1:1810 E COLLEGE WAY STE 132
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2362
Practice Address - Country:US
Practice Address - Phone:360-428-3066
Practice Address - Fax:866-576-2195
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor