Provider Demographics
NPI:1023526076
Name:ZIEBARTH, TYLER (MA, MHP, LMHCA)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:ZIEBARTH
Suffix:
Gender:M
Credentials:MA, MHP, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 NW BOWDOIN PL APT 204
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4934
Mailing Address - Country:US
Mailing Address - Phone:321-278-0153
Mailing Address - Fax:
Practice Address - Street 1:1622 3RD ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-5004
Practice Address - Country:US
Practice Address - Phone:407-490-0552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60757388101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health