Individual
MR. TYLER MARC BOHNET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
OR 4082
OR
225100000X
Physical Therapist
PT 00008327
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226568
—
OR
01
—
30062200
REGENCE HMO
—
01
—
825473002
REGENCE PPO
—
01
—
K981106
PACIFIC SOURCE
—
Enumeration date
01/11/2006
Last updated
11/19/2008
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