Organization
R TYLER REIDENBAUGH MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT TYLER REIDENBAUGH MD (ATTENDING PHYSICIAN)
(405) 313-6080
Entity
Organization
Contact information
Practice address
12101 AMBAUM BLVD SW, BURIEN, WA 98146-2651
(206) 244-8100
Mailing address
4710 40TH AVE SW STE N408, SEATTLE, WA 98116-4674
(405) 313-6080
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
02/01/2019
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