Provider Demographics
NPI:1376305276
Name:LOVINS, TYLOR S
Entity Type:Individual
Prefix:
First Name:TYLOR
Middle Name:S
Last Name:LOVINS
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 1:1503 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2025
Mailing Address - Country:US
Mailing Address - Phone:765-278-8754
Mailing Address - Fax:
Practice Address - Street 1:1900 NW DOCK PL STE 34&7
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4846
Practice Address - Country:US
Practice Address - Phone:206-274-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health