Active NPI
Tyra Elaine Anderson
- Counselor
- Seattle, WA
National Provider Identifier
1043036551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG61312780
- Practice address
- 2120 S Plum St
Seattle, WA 98144-4539 - Phone
- (206) 441-3043
- NPI assigned
- Nov 29, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG61312780 | WA | Primary |
Addresses
Primary practice location
2120 S Plum St
Seattle, WA 98144-4539
Mailing address
2120 S Plum St
Seattle, WA 98144-4539
Phone (206) 441-3043
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG61312780 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1043036551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2120 S PLUM ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981444539",
"telephone_number": "206-441-3043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 S PLUM ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981444539",
"telephone_number": "206-441-3043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "TYRA",
"middle_name": "ELAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-29",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG61312780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.