Provider Demographics
NPI:1114529443
Name:SHELDON, TYLER JEFFREY (DPT)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:JEFFREY
Last Name:SHELDON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 4TH AVE NW STE 300
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-9371
Mailing Address - Country:US
Mailing Address - Phone:425-395-7317
Mailing Address - Fax:425-395-7319
Practice Address - Street 1:1301 4TH AVE NW STE 300
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-9371
Practice Address - Country:US
Practice Address - Phone:425-395-7317
Practice Address - Fax:425-395-7319
Is Sole Proprietor?:No
Enumeration Date:2020-11-11
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12921225100000X
WAPT61320329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist