Individual provider Active NPI

Ryan Tustin

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1629946058
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC70026234 Issued in WA
Practice address
1498 SE Tech Center PL Ste 300
Vancouver, WA 98683-5509
Phone
(360) 619-2226
Fax
(360) 326-9691
NPI assigned
Oct 27, 2025
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC70026234 WA Primary

Addresses

Primary practice location

1498 SE Tech Center PL Ste 300
Vancouver, WA 98683-5509

Mailing address

625 SE 16TH Ave Apt 2
Portland, OR 97214-2615
Phone (360) 619-2226

Other practice location 1

3606 Main St Ste 205
Vancouver, WA 98663-2235
Phone (360) 619-2226

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

LicenseStateTypeSpecialty
MC70026234WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Real Life Counseling PLLC CurrentSince Nov 8, 2025 Accepting new patients

Locations

1498 SE Tech Center Pl
Ste 300
Vancouver, WA 98683
Phone (360) 567-2200

3606 Main St
Ste 205
Vancouver, WA 98663
Phone (360) 200-8670

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1629946058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SE 16TH AVE APT 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142615",
            "telephone_number": "360-619-2226",
            "fax_number": "360-326-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835509",
            "telephone_number": "360-619-2226",
            "fax_number": "360-326-9691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3606 Main St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986632235",
            "country_code": "US",
            "telephone_number": "360-619-2226",
            "fax_number": "360-326-9691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUSTIN",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC70026234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.