Tulalip Clinical Pharmacy is a medicare enrolled primary clinic (Family Medicine) in Quil Ceda Village, Washington. The current practice location for Tulalip Clinical Pharmacy is 8825 34th Ave Ne Ste A, Quil Ceda Village, Washington. For appointments, you can reach them via phone at
(357) 716-4000. The mailing address for Tulalip Clinical Pharmacy is 8825 34th Ave Ne Ste A, Quil Ceda Village, Washington and phone number is (357) 716-4000.
Tulalip Clinical Pharmacy is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1376164962. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(357) 716-4000.
Primary Care Clinic Profile
| Full Name | Tulalip Clinical Pharmacy |
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| Speciality | Family Medicine |
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| Location | 8825 34th Ave Ne Ste A, Quil Ceda Village, Washington |
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| Authorized Official Name and Position | Kelvin Lee (DIRECTOR / AUTHORIZED OFFICIAL) |
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| Authorized Official Contact | 3607162660 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Tulalip Clinical Pharmacy
8825 34th Ave Ne Ste A
Quil Ceda Village
WA 98271-8085
Ph: (357) 716-4000 | Tulalip Clinical Pharmacy
8825 34th Ave Ne Ste A
Quil Ceda Village
WA 98271-8085
Ph: (357) 716-4000 |
NPI Details:
| NPI Number | 1376164962 |
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| Provider Enumeration Date | 05/05/2020 |
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| Last Update Date | 05/05/2020 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 4880857275 |
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| Medicare Enrollment ID | O20201118000976 |
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Medical Identifiers
Medical identifiers for Tulalip Clinical Pharmacy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1376164962 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Tulalip Clinical Pharmacy acts as a billing entity for following providers:
| Provider Name | Pavel Conovalciuc |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1720017080
PECOS PAC ID: 4587673504
Enrollment ID: I20201118001340 |
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