Individual
TYLER AUSTIN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3000 LANDERHOLM CIR SE, BELLEVUE, WA 98007-6484
(425) 466-3781
Mailing address
11453 69TH PL S, SEATTLE, WA 98178-3002
(425) 466-3781
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN61080655
WA
364SA2100X
Acute Care Clinical Nurse Specialist
RN61080655
WA
390200000X
Student in an Organized Health Care Education/Training Program
RN61080655
WA
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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