Provider Demographics
NPI:1477799534
Name:TYLER, RONALD JAMES (MSPT)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JAMES
Last Name:TYLER
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 869
Mailing Address - Street 2:
Mailing Address - City:WAUNA
Mailing Address - State:WA
Mailing Address - Zip Code:98395-0869
Mailing Address - Country:US
Mailing Address - Phone:360-710-5444
Mailing Address - Fax:360-925-3305
Practice Address - Street 1:23552 NE STATE ROUTE 3 STE 2B
Practice Address - Street 2:
Practice Address - City:BELFAIR
Practice Address - State:WA
Practice Address - Zip Code:98528-9300
Practice Address - Country:US
Practice Address - Phone:360-205-3237
Practice Address - Fax:360-925-3305
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5488225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist