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Individual
TYRA L MALMBORG OKELLEY
Active
Individual
TYRA L MALMBORG OKELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201977
DEPT. OF LABOR & INDUSTRY
WA
01
—
0264717
DEPT OF L&I
WA
01
—
0562MA
REGENCE
WA
01
—
2358MA
REGENCE BLUE SHIELD
WA
01
—
4524MA
REGENCE BLUE SHIELD
WA
01
—
5028MA
REGENCE BLUE SHIELD
WA
01
—
5066111
AETNA
WA
01
—
5342MA
REGENCE BLUE SHIELD
WA
05
—
8385379
—
WA
01
—
8542MA
REGENCE BLUE SHIELD
WA
01
—
8875MA
REGENCE BLUE SHIELD
WA
01
—
8935654
L&I CRIME VICTIMS
WA
01
—
911745305-98203-C007
TRICARE
WA
01
—
911745305-98275-A004
TRICARE
WA
Enumeration date
05/28/2006
Last updated
12/03/2014
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