Provider Demographics
NPI:1194929968
Name:TYLER, JULIANA K (MA, LMHC, NCC)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:K
Last Name:TYLER
Suffix:
Gender:F
Credentials:MA, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1604
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-7804
Mailing Address - Country:US
Mailing Address - Phone:206-604-0996
Mailing Address - Fax:
Practice Address - Street 1:144 RAILROAD AVE STE 205C
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-4121
Practice Address - Country:US
Practice Address - Phone:206-604-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health