Provider Demographics
NPI:1477225779
Name:CHRISTENSEN, TYLER MICHAEL (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:MICHAEL
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12724 LAKE CITY WAY NE APT A201
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4444
Mailing Address - Country:US
Mailing Address - Phone:715-563-1504
Mailing Address - Fax:
Practice Address - Street 1:3601 FREMONT AVE N STE 210
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8753
Practice Address - Country:US
Practice Address - Phone:206-548-1522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT611889942251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic