Individual
DR. TYLER DOUGLASS GIBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 NE MOTHER JOSEPH PL, VANCOUVER, WA 98664-3200
(360) 425-5131
(360) 425-5509
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD00034512
WA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD00034512
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0383458
L&I-RADIA VANCOUVER
WA
01
—
0383459
L&I-RADIA SEATTLE
WA
01
—
0402006
L&I-SEATTLE RADIOLOGY
WA
01
—
0415512
L&I-SOUTH SOUND RADIOLOGY
WA
01
—
0422055
L&I-SWEDISH RADIA EDMONDS
WA
01
—
0422056
L&I-EVERGREEN RADIA
WA
05
—
1005976
—
WA
05
—
150946
—
OR
Enumeration date
01/17/2006
Last updated
07/02/2024
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