Active NPI
Tyran Keith Schroyer
- Counselor
- Mount Vernon, WA
National Provider Identifier
1609153121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG60247123
- Practice address
- 1010 E College Way
Mount Vernon, WA 98273-5624 - Phone
- (360) 428-8912
- Fax
- (360) 424-6288
- NPI assigned
- Nov 11, 2011
- Sex
- Male
- 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 | CG60247123 | WA | Primary |
Addresses
Primary practice location
1010 E College Way
Mount Vernon, WA 98273-5624
Mailing address
PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-3335
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 |
|---|---|---|---|
| CG60247123 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320969600000",
"number": "1609153121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34703",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241703",
"telephone_number": "206-764-3335",
"fax_number": "206-764-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 E COLLEGE WAY",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982735624",
"telephone_number": "360-428-8912",
"fax_number": "360-424-6288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROYER",
"first_name": "TYRAN",
"middle_name": "KEITH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-11",
"last_updated": "2011-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60247123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.