NPIMap

Organization Active NPI

Tulalip Tribes of Washington Quil Ceda Creek Counseling

  • Methadone Clinic
  • Tulalip, WA
National Provider Identifier
1699356683
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING
Doing business as
Quil Ceda Creek Counseling Company
Practice address
6330 31St Ave NE Ste 101
Tulalip, WA 98271-7423
Phone
(360) 716-2200
NPI assigned
Apr 20, 2021
Organization subpart
Yes
Parent organization
TULALIP TRIBES OF WASHINGTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Tanya Burns
Title
Administrator
Phone
(360) 716-2200

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Methadone Clinic 261QM2800X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

6330 31St Ave NE Ste 101
Tulalip, WA 98271-7423

Mailing address

6330 31St Ave NE Ste 101
Tulalip, WA 98271-7423
Phone (360) 716-2200

Other names 1

  • Quil Ceda Creek Counseling Company Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Opioid treatment program
Medicare-enrolled since Jun 17, 2023

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230831003487 WA Part B Supplier - Opioid Treatment Program (Otp) 0547627291 Practice locations: Tulalip, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Tulalip Tribes of Washington Quil Ceda Creek Counseling2 organizations share this tax ID, including this one
Part of
Tulalip Health Clinic

Other organizations with this tax ID 1

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

Locations

8802 27th Ave NE
Quil Ceda Village, WA 98271

6330 31st Ave NE
#101
Tulalip, WA 98271
Phone (360) 716-2200

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1699356683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 31ST AVE NE STE 101",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "982717423",
            "telephone_number": "360-716-2200",
            "fax_number": "360-716-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 31ST AVE NE STE 101",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "982717423",
            "telephone_number": "360-716-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULALIP TRIBES OF WASHINGTON QUIL CEDA CREEK COUNSELING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TULALIP TRIBES OF WASHINGTON",
        "enumeration_date": "2021-04-20",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "360-716-2200"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quil Ceda Creek Counseling Company",
            "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 Feb 21, 2023; 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.