Timothy Tackels, CP 00002256

NPI 1023465176 · on the registry since 2016 · sole proprietor

Practice

Address: 1601 E College Way
Mount Vernon, WA 98273
Phone: (360) 848-8437
Organisation at this address: Phoenix Recovery House
Phoenix Recovery Services, Llc
Phoenix Recovery Services, Llc
Consejo Conseling And Referral Services
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 38

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Licence states on file: WA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2016-05-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington