MR. TYLER LEE ANDERSON (NPI# 1083927792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083927792 |
| Entity Type | Individual |
| Full Name | MR. TYLER LEE ANDERSON |
| Credential | PA-C |
| Practice Address |
1119 Highland Ave Ste 4 Clarkston WA 99403-2836 |
| Practice Telephone | 5092540080 |
| Practice Fax Number | 5092540079 |
| Mailing Telephone | 5092540080 |
| Mailing Fax Number | 5092540079 |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2010-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10003435 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738972 | Tyler Chad Anderson | Physical Therapist | 701 3rd Ave Ne, Hillsboro, ND 58045-4618 | 2020-10-23 |
| 1700357845 | Tyler James Anderson | Driver | 39100 Contreras Rd Ste D, Anza, CA 92539-8724 | 2018-12-16 |
| 1326573924 | Tyler Anderson | Behavioral Analyst | 620 N Lawler St, Mitchell, SD 57301-2639 | 2017-04-21 |
| 1447612478 | Tyler John Anderson | Ophthalmology | 7590 Hospital Dr Bldg C204, Gloucester, VA 23061-4178 | 2016-03-29 |
| 1992144422 | Tyler Anderson | Physical Therapist | 3801 Selsa Rd Ste 7, Independence, MO 64057-1712 | 2013-06-18 |
| 1407464811 | Tyler Douglas Anderson | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-9003 | 2020-07-21 |
| 1689291635 | Tyler Anderson | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-06-25 |
| 1720634793 | Tyler Anderson | Behavior Technician | 14427 Meridian Pkwy Ste E, March Air Reserve Base, CA 92518-3015 | 2019-08-14 |
| 1134697097 | Tyler Anderson | Case Manager/Care Coordinator | 525 Alexander St, Jonesboro, LA 71251 | 2018-11-08 |
| 1336645191 | Tyler Anderson | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd Ste 308, Tampa, FL 33606-3438 | 2018-04-02 |
| Street Address |
1119 HIGHLAND AVE STE 4 |
| City | CLARKSTON |
| State | WA |
| Zip Code | 99403-2836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306409669 | Jessica Elaine Krull | Specialist/Technologist | 807 3rd Street, Clarkston, WA 99403 | 2019-04-22 |
| 1477006526 | Idaho County Rideshare | Non-emergency Medical Transport (VAN) | 1470 Elm Street, Clarkston, WA 99403 | 2016-07-25 |
| 1679921340 | Jonathan Preszler | Counselor | 629 6th Street, Educational and Psychological Services, Clarkston, WA 99403 | 2016-06-02 |
| 1104204957 | Optimal Health and Wellness | Clinic/Center | 1267 Belmont Way, Clarkston, WA 99403 | 2015-05-13 |
| 1326456351 | David Nygren | Pharmacist | 506 5th St, Clarkston, WA 99403 | 2014-07-22 |
| 1255672895 | Alpowa Healthcare, Inc. | Hospice Care, Community Based | 1370 Bridge Street, Clarkston, WA 99403 | 2013-03-06 |
| 1265799407 | Elizabeth Bagnulo Dacey | Pathology | 1225 Highland Avenue, Clarkston, WA 99403 | 2012-04-12 |
| 1649586256 | Zeeshan Afzal | Internal Medicine | 1119 Highland Ave Ste 3, Clarkston, WA 99403 | 2010-08-20 |
| 1154657955 | Twin River Vision, Inc. | Optometrist | 306 5th Street, Clarkston, WA 99403 | 2009-10-29 |
| 1649429317 | Elizabeth Marie Allen-racicot | Specialist | 1013 Bridge Street, Clarkston, WA 99403 | 2008-09-17 |
| Find all providers in zip 99403 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235684143 | Michael Sean Muldowney | Physician Assistant | 5701 Bow Pointe Dr Ste 100, Clarkston, MI 48346-3199 | 2016-08-20 |
| 1649643263 | Michael Engler | Physician Assistant | 5701 Bow Pointe Dr, Clarkston, MI 48346-3198 | 2015-11-04 |
| 1407272578 | Kelly Anne Dooley Swanson | Physician Assistant | 5701 Bow Pointe Dr Ste 215, Clarkston, MI 48346-5400 | 2014-03-12 |
| 1295983518 | Kari Leigh Hoekstra | Physician Assistant | 5701 Bow Pointe Drive, Suite 100, Clarkston, MI 48346-3199 | 2008-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735618 | Gavin Guard | Physician Assistant | 818 Mullis St Ste 6, Friday Harbor, WA 98250-7986 | 2020-06-19 |
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1841791274 | Sjs, Pllc | Physician Assistant | 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 | 2018-02-21 |
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1194251983 | Christopher Joseph Stanley | Physician Assistant | 1010 Ne Lilac St Apt 301, Issaquah, WA 98029-7878 | 2017-05-11 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1801344601 | Jessica Ann Pettitt | Physician Assistant | 21200 Ne 190th Ct, Battle Ground, WA 98604-9636 | 2016-09-21 |
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.