Provider Demographics
NPI:1407429293
Name:ULIN, TYLER
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:ULIN
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 1:631 STRANDER BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2963
Mailing Address - Country:US
Mailing Address - Phone:125-385-0250
Mailing Address - Fax:
Practice Address - Street 1:631 STRANDER BLVD STE A
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2963
Practice Address - Country:US
Practice Address - Phone:125-385-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor