Provider Demographics
NPI:1851358436
Name:SCHEINOST, TYLER ALDEN (DPM)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:ALDEN
Last Name:SCHEINOST
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E PIONEER
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3264
Mailing Address - Country:US
Mailing Address - Phone:253-840-4090
Mailing Address - Fax:253-840-4931
Practice Address - Street 1:324 E PIONEER
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3264
Practice Address - Country:US
Practice Address - Phone:253-840-4090
Practice Address - Fax:253-840-4931
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000662213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA912058729OtherTAX ID
WA1111046Medicaid
WA1851358436OtherNPI
WA9058884OtherMEDICAID DME
WA912058729OtherTAX ID
WA1111046Medicaid