Tyler Austin Willis, RN

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

RN61080655 Issued in WA

Practice address

3000 Landerholm Cir SE
Bellevue, WA 98007-6484

Phone

(425) 466-3781

NPI assigned

Sep 16, 2024

Last updated

Sep 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1205663069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11453 69TH PL S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981783002",
            "telephone_number": "425-466-3781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 LANDERHOLM CIR SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980076484",
            "telephone_number": "425-466-3781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11453 69th Pl S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981783002",
            "country_code": "US",
            "telephone_number": "425-466-3781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "TYLER",
        "middle_name": "AUSTIN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "WA",
            "license": "RN61080655",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "RN61080655",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "WA",
            "license": "RN61080655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay C Williamson, M.A.
• John Williamson
• Laura Williamson, EDD, MAC, LMHC
• Mackenzie Williamson
• Ashley Kayanna Willis, MS, LABA
• Corey James Willits
• Ashton Elizabeth Wills
• Ryan W Willsey, LMP
• Sarah J Willsie, LMP
• Elizabeth Willsmore-Finkle, MOT, OTR/L

• Critical Care Medicine Registered Nurse in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Critical Care Medicine Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.