Tyler Tompkins Sengamphan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61420235 Issued in WA

Practice address

17012 Aurora Ave N Ste 101
Shoreline, WA 98133-5315

Phone

(206) 788-8807

Fax

(206) 801-7780

NPI assigned

Jul 10, 2023

Sex

Male

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

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Prevail Practices, PLLC

  • Physical Therapist
  • Shoreline, WA
  • NPI 1740723915
  Medicare reassignment NPD

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1841978764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5507 KENWOOD PL N APT 103",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035952",
            "telephone_number": "425-877-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17012 AURORA AVE N STE 101",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335315",
            "telephone_number": "206-788-8807",
            "fax_number": "206-801-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENGAMPHAN",
        "first_name": "TYLER",
        "middle_name": "TOMPKINS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61420235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Anna Seitz, LMHCA
• Jayna Sekijima, DDS
• Kaytlin Marie Seldon
• Talle Selhorst
• Lonnie R Sellers, PT
• Sachiko Senteno, OTR/L
• Joseph Seo
• Fikirte Addisu Setargew, RN
• Marlene Bowman Sexton, LMFT
• Laxmi Shah, D.C

• Physical Therapist in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.