Healthcare Provider Details

I. General information

NPI: 1386271856
Provider Name (Legal Business Name): TYLER DANIEL COOLMAN DO, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 S MERIDIAN
PUYALLUP WA
98371-7590
US

IV. Provider business mailing address

1703 S MERIDIAN
PUYALLUP WA
98371-7590
US

V. Phone/Fax

Practice location:
  • Phone: 253-446-3904
  • Fax: 253-447-1641
Mailing address:
  • Phone: 253-446-3904
  • Fax: 253-447-1641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberOP61528036
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: