R Tyler Reidenbaugh MD PLLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

R TYLER REIDENBAUGH MD PLLC

Practice address

12101 Ambaum Blvd SW
Burien, WA 98146-2651

Phone

(206) 244-8100

NPI assigned

Sep 20, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Robert Tyler Reidenbaugh, MD

Title

Attending Physician

Phone

(405) 313-6080

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1316421803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 40TH AVE SW STE N408",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164674",
            "telephone_number": "405-313-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 AMBAUM BLVD SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981462651",
            "telephone_number": "206-244-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R TYLER REIDENBAUGH MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "REIDENBAUGH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "ATTENDING PHYSICIAN",
        "authorized_official_telephone_number": "405-313-6080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anand Pullat, DDS, MHA
• Nancy Purcell, MD
• Brian V Quach, PAC
• Paul Quinlivan
• R Skoglund M D PLLC (Rodney D. Skoglund, M.D.)
• R. David Mtchell
• Desmond Rabinowitz, MD
• Shannon Marie Radoll, CD
• Meg Rafanelli
• Cassandra Raihl

• Substance Abuse Rehabilitation Facility in Burien, WA
• Providers in Burien, WA by specialty
• Substance Abuse Rehabilitation Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.