R TYLER REIDENBAUGH MD PLLC (NPI# 1316421803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316421803 |
| Entity Type | Organization |
| Organization Name | R TYLER REIDENBAUGH MD PLLC |
| Practice Address |
12101 Ambaum Blvd Sw Burien WA 98146-2651 |
| Mailing Address |
4710 40th Ave Sw Ste N408 Seattle WA 98116-4674 |
| Practice Telephone | 2062448100 |
| Mailing Telephone | 4053136080 |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2019-02-01 |
| Authorized Official Name | DR. ROBERT TYLER REIDENBAUGH (ATTENDING PHYSICIAN) |
| Authorized Official Telephone | 4053136080 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
12101 AMBAUM BLVD SW |
| City | BURIEN |
| State | WA |
| Zip Code | 98146-2651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164538062 | Duffy I, Lp | Rehabilitation Hospital | 12101 Ambaum Blvd Sw, Burien, WA 98146-2651 | 2006-08-22 |
| 1487097762 | Robert Tyler Reidenbaugh | Psychiatry & Neurology | 12101 Ambaum Blvd Sw, Burien, WA 98146 | 2013-04-16 |
| 1588832257 | Duffy Physicians, P.s. | Special Hospital | 12101 Ambaum Blvd Sw, Burien, WA 98146-2651 | 2008-02-15 |
| 1497880355 | John R Moran | Psychiatry & Neurology | 12101 Ambaum Blvd Sw, Burien, WA 98146-2651 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063998946 | Vinh T Nguyen | Pharmacist | 10248- 17th Ave Sw, Seattle, WA 98146 | 2018-07-13 |
| 1386032233 | Bowie James Mclean | Counselor | 480 Sw 134th St, Burien, WA 98146 | 2014-12-30 |
| 1518367200 | Joy Hilliker | Counselor | 10803 44th Ave Sw, Seattle, WA 98146 | 2014-08-29 |
| 1841534344 | Phuonglinh Tran | Speech-Language Pathologist | 10811 12th Avenue Southwest, Seattle, WA 98146 | 2012-11-21 |
| 1174867741 | Dorothy Winkler Phelps | Registered Nurse | 2725 Sw116th Street, Burien, WA 98146 | 2012-11-20 |
| 1578829529 | Aaron Thomas Kent | Massage Therapist | 304 Sw 106th St, Seattle, WA 98146 | 2012-04-04 |
| 1154651933 | Robert Anthony Yap | Nurse Practitioner | 12459 Ambaum Blvd S.w., Unit A, Burien, WA 98146 | 2009-12-30 |
| 1952536690 | Renee Dorothea Patterson | Massage Therapist | 11645 23rs Ave Sw, Seattle, WA 98146 | 2009-05-26 |
| 1518125368 | Leeanne Casal | Massage Therapist | 10223 16th Sw, Seattle, WA 98146 | 2008-05-29 |
| 1629299474 | Bryn Annette Karlberg | Massage Therapist | 12263 Shorewood Drive Sw, Seattle, WA 98146 | 2007-05-01 |
| Find all providers in zip 98146 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730787763 | For The Culture Counseling Services | Substance Abuse Rehabilitation Facility | 4301 S Pine St Ste 92, Tacoma, WA 98409-7259 | 2020-10-12 |
| 1760090518 | Hotel California By The Sea Bellevue, LLC. | Substance Abuse Rehabilitation Facility | 7810 130th Ave Ne, Kirkland, WA 98033-8251 | 2020-07-17 |
| 1629532569 | Sandra Ann Moore | Substance Abuse Rehabilitation Facility | 2632 E 17th St, Bremerton, WA 98310-5058 | 2019-01-24 |
| 1972085835 | Peninsula Counseling, LLC | Substance Abuse Rehabilitation Facility | 3214 50th Street Ct Nw Ste D-305, Gig Harbor, WA 98335-8589 | 2018-09-06 |
| 1356831911 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 44 E Cozza Dr Ste B, Spokane, WA 99208-6514 | 2018-05-18 |
| 1609365238 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 500 Se Adams Ave, Chehalis, WA 98532 | 2018-05-09 |
| 1023515400 | Evergreen Recovery Centers | Substance Abuse Rehabilitation Facility | 1905 Continental Place, Mount Vernon, WA 98273 | 2018-04-11 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1346785524 | Big Change Medical | Substance Abuse Rehabilitation Facility | 26857 16th Ave S, Des Moines, WA 98198-9327 | 2016-12-27 |
| 1881062362 | Sea-mar Community Health Center | Substance Abuse Rehabilitation Facility | 113 23rd Ave S, Seattle, WA 98144-2309 | 2015-09-14 |
| 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.