Individual provider Active NPI

Sandra Shauna Tallar, MS

  • Mental Health Counselor
  • Everett, WA
National Provider Identifier
1164897724
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC 60235259 Issued in WA
Practice address
3305 Oakes Ave
Everett, WA 98201-4409
Phone
(425) 785-6719
NPI assigned
Dec 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC 60235259 WA Primary

Addresses

Primary practice location

3305 Oakes Ave
Everett, WA 98201-4409

Mailing address

PO Box 1881
Lynnwood, WA 98046-1881
Phone (425) 785-6719

Other practice location 1

20102 Cedar Valley Rd Ste 204
Lynnwood, WA 98036-6333
Phone (425) 338-7589

Other identifiers 1

IdentifierTypeStateIssuer
1770768889OtherWAANGELA OLSON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250326002568 WA Practitioner - Mental Health Counselor 0840713244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

20102 Cedar Valley Rd
Suite 204
Lynnwood, WA 98036-6392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MC 60235259WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Angela Olson LMHC LLC Mental Health CurrentSince Dec 16, 2024 Accepting new patients

Locations

3305 Oakes Ave
Everett, WA 98201
Phone (425) 236-5520

3305 Oakes Ave
#100
Everett, WA 98201
Phone (425) 338-7589

20102 Cedar Valley Rd
Ste 204
Lynnwood, WA 98036
Phone (425) 280-0002

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1164897724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1881",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980461881",
            "telephone_number": "425-785-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 OAKES AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014409",
            "telephone_number": "425-785-6719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20102 Cedar Valley Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980366333",
            "country_code": "US",
            "telephone_number": "425-338-7589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLAR",
        "first_name": "SANDRA",
        "middle_name": "SHAUNA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC 60235259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANGELA OLSON",
            "identifier": "1770768889",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.