Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD60854608 | WA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD60854608 | WA |
NPI | 1336439116 |
---|---|
Provider Name | Tyler Kent |
First Address | Everett, WA 98201-3788 |
Second Address | Everett, WA 98201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2011 |
Last Update Date | 17/07/2018 |