Marissa Tyler, DC

Primary specialty

Pediatric ChiropractorTaxonomy code 111NP0017X

License

CH61402370 Issued in WA

Practice address

909 W Main St Ste 105
Battle Ground, WA 98604-4884

Phone

(360) 949-0936

NPI assigned

May 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fireside Chiropractic, L.L.C.

  dba Fireside Chiropractic

  • Chiropractor
  • Battle Ground, WA
  • NPI 1407207665
  NPD

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1376235267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 NW 16TH CIR",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W MAIN ST STE 105",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044884",
            "telephone_number": "360-949-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "MARISSA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "WA",
            "license": "CH61402370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Tretiakova, CPNP-PC, DNP
• Michelle Truax, LMP
• Truscinski & Kockritz DDS (Battle Ground Dental)
• Erica Tsikirai
• Ruth A Tucker, RPH
• US Veterns Hospital Pharmacy
• Elizabeth Anne Vader, DC
• Cody Vandersloot
• Eva Venegas, LMT
• Victory Rehabilitation and Healthcare Center, LLC

• Pediatric Chiropractor in Battle Ground, WA
• Providers in Battle Ground, WA by specialty
• Pediatric Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.