Active NPI
Tyler Comstock
- Speech-Language Pathologist
- Walla Walla, WA
National Provider Identifier
1154803807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 60887346
- Practice address
- 364 S Park St
Walla Walla, WA 99362-3249 - Phone
- (509) 527-3000
- NPI assigned
- Aug 29, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 60887346 | WA | Primary |
Addresses
Primary practice location
364 S Park St
Walla Walla, WA 99362-3249
Mailing address
719 Juniper St
Walla Walla, WA 99362-3435
Phone (813) 777-6667
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 |
|---|---|---|---|
| 60887346 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1154803807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 JUNIPER ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993623435",
"telephone_number": "813-777-6667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "364 S PARK ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993623249",
"telephone_number": "509-527-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMSTOCK",
"first_name": "TYLER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-29",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "60887346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.