Provider Demographics
NPI:1023741659
Name:STEBBINS, TYLER MICHAEL
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:MICHAEL
Last Name:STEBBINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 E CHERRY ST APT I
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4564
Mailing Address - Country:US
Mailing Address - Phone:206-795-0541
Mailing Address - Fax:
Practice Address - Street 1:2601 JAHN AVE NW STE A6
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8900
Practice Address - Country:US
Practice Address - Phone:253-202-0793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health