Provider Demographics
NPI:1821873423
Name:ZIVEC, TYANA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:TYANA
Middle Name:MARIE
Last Name:ZIVEC
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 RIGNEY RD APT C25
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-2831
Mailing Address - Country:US
Mailing Address - Phone:210-415-5821
Mailing Address - Fax:
Practice Address - Street 1:BRIAN D ALLGOOD ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:BLDG 3031
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96271
Practice Address - Country:US
Practice Address - Phone:050-333-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK212990225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist