Healthcare Provider Details

I. General information

NPI: 1912741935
Provider Name (Legal Business Name): MADISON K TYLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 HILDEBRAND LN NE STE 220
BAINBRIDGE ISLAND WA
98110-2877
US

IV. Provider business mailing address

2400 NW MYHRE RD STE 101
SILVERDALE WA
98383-7672
US

V. Phone/Fax

Practice location:
  • Phone: 206-842-6288
  • Fax: 360-598-3282
Mailing address:
  • Phone: 360-598-3764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: