Teylor Hendricks, ARNP, FNP, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · La Conner, WA
NPI 1225520554 · NPPES record last updated Jul 30, 2026
Key facts
- NPI
- 1225520554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- AP60877595 (WA)
- Practice address
- 17400 Reservation Rd
La Conner, WA 98257-8801 - Phone
- (360) 466-3167
- NPI assigned
- Jun 1, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250729001442 | WA | Practitioner - Nurse Practitioner | 6406194273 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60765561 | WA | MD | Registered Nurse |
| AP60877595 | WA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services- Washington | Current |
Accepting new patients | |
| Providence Health & Services-Washington | Current |
Accepting new patients | |
| Providence Health & Services-Wa | Current |
Accepting new patients | |
| Providence Health & Services - Washington | Current |
Accepting new patients |
Locations
1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413
900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311
4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330
Interoperability endpoints
- teylor.wilbur@swin.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 60765561 | WA | |
| Family Nurse Practitioner | 363LF0000X | AP60877595 | WA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP60877595 | WA | Yes |
Addresses
Primary practice location
17400 Reservation Rd
La Conner, WA 98257-8801
Mailing address
17400 Reservation Rd
La Conner, WA 98257-8801
Phone (360) 466-3167
Other providers in La Conner, WA
- Asiah Jeanmarie Gonzalez
- Steven Bruce Gooding
- Alexis Govan
- Patricia J Harlan
- Marianne Haworth
- Rachael R Hogan
- Tamara M Holmes
- Internal Medicine Consultants NW PS
- Gary Clayton Isham
- Justin Iwasaki
All providers in La Conner, WA · Psychiatric/Mental Health Nurse Practitioner in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.