Tyler Jacob Shrofe
Individual provider Active NPI Homemaker · Tumwater, WA
NPI 1609228063 · NPPES record last updated Jul 11, 2016
Key facts
- NPI
- 1609228063
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- Practice address
- 5701 6TH Ave SW
F-2
Tumwater, WA 98501-8507 - Phone
- (360) 915-8778
- NPI assigned
- Jul 11, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | WA | ||
| Homemaker | 376J00000X | WA | Yes |
Addresses
Primary practice location
5701 6TH Ave SW
F-2
Tumwater, WA 98501-8507
Mailing address
2725 26TH Ave NE
Olympia, WA 98506-2908
Phone (360) 970-0209
Other providers in Tumwater, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.