NPIMap

Organization Active NPI

Tulalip Tribes of Washington

  • Public Health & General Preventive Medicine Physician
  • Tulalip, WA
National Provider Identifier
1013138924
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
Legal business name
TULALIP TRIBES OF WASHINGTON
Practice address
2821 Mission Hill Rd
Tulalip, WA 98271
Phone
(360) 716-4400
Fax
(360) 716-5789
NPI assigned
May 1, 2007
Reactivated
May 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gary Ferguson, ND
Title
Interim Health System Administrator
Phone
(360) 716-5675

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

2821 Mission Hill Rd
Tulalip, WA 98271

Mailing address

6406 Marine Dr Ste a
Tulalip, WA 98271
Phone (360) 651-4400

Other identifiers 1

IdentifierTypeStateIssuer
2036113MedicaidWA

Other names 1

  • Tulalip Tribes Family Services - Adult Mental Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160615001117 TX Part B Supplier - Clinic/Group Practice 7719879782 Receives reassigned benefits from 49 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tulalip, WA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Tulalip Health Clinic13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1013138924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 MARINE DR STE A",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "98271",
            "telephone_number": "360-651-4400",
            "fax_number": "360-716-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 MISSION HILL RD",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "98271",
            "telephone_number": "360-716-4400",
            "fax_number": "360-716-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULALIP TRIBES OF WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "deactivation_date": "2014-04-10",
        "reactivation_date": "2014-05-09",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "INTERIM HEALTH SYSTEM ADMINISTRATOR",
        "authorized_official_telephone_number": "360-716-5675",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2036113",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tulalip Tribes Family Services - Adult Mental Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulalip, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.