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WILLOW KOPRA TUCKER
NPI 1053890814
Counselor - Mental Health in Poulsbo, WA

Active since August 12, 2018PECOS Enrolled
2781 NW BIRKENFELD WAY, POULSBO, WA 98370(425) 647-9640 Get Directions Write a Review

NPPES record last updated: November 5, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 5, 2024, May 4, 2024, Aug 12, 2018 (3 updates tracked since 2018).

About Willow Kopra Tucker NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLOW KOPRA TUCKER (NPI 1053890814) is an individual mental health provider in Poulsbo, Washington, licensed in Washington (60891614) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053890814
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameWILLOW KOPRA TUCKER
Location Address2781 NW BIRKENFELD WAYPoulsbo, WA 98370-8093
Mailing Address2781 Nw Birkenfeld WayPoulsbo, WA 98370-8093 · (425) 647-9640
Phone(425) 647-9640
Sole ProprietorNo
Enumeration DateAugust 12, 2018
Last NPPES UpdateNovember 5, 20243 updates tracked since enumeration
NPPES CertifiedNovember 5, 2024
✔ NPI 1053890814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WA · 60891614
2781 NW BIRKENFELD WAY, Poulsbo, WA 98370
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Premera Blue Cross Blue Shield of Alaska and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Willow Kopra Tucker is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Willow Tucker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mindful Therapy Group PC
17 mi
Clinical
6505 216TH ST SW STE 100
Mountlake Terrace, WA 98043
  • Reassigned Medicare billing, Washington enrollment
  • 777 clinicians in this Medicare group
NPI 1316238678 (425) 640-7009

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willow Tucker's NPI number?

The NPI number for Willow Tucker is 1053890814. It was assigned to this individual provider in the NPPES registry on August 12, 2018.

Where is Willow Tucker located?

Willow Tucker practices at 2781 NW Birkenfeld Way, Poulsbo, WA 98370. The listed phone number is (425) 647-9640.

What is Willow Tucker's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Willow Tucker enrolled in Medicare?

Yes. Willow Tucker is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Willow Tucker's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Willow Tucker reassigns Medicare benefits to Mindful Therapy Group PC (Mountlake Terrace, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Willow Tucker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Willow Tucker accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Premera Blue Cross Blue Shield of Alaska and Regence BlueCross BlueShield of Oregon list Willow Tucker as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Willow Tucker was last updated on November 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.