Provider Demographics
NPI:1831845965
Name:WEED, TYLER JON (ND)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:JON
Last Name:WEED
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-1906
Mailing Address - Country:US
Mailing Address - Phone:425-777-0530
Mailing Address - Fax:207-230-1134
Practice Address - Street 1:91 ELM ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1906
Practice Address - Country:US
Practice Address - Phone:425-777-0530
Practice Address - Fax:207-230-1134
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MENP738175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath