Doctor Name: | DR. BRAD TYSON |
NPI Number: | 1952704413 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | PSYC.PY.60458583 |
Business Practice Address: | 24217 139th Ave Se Kent, WA - 980425166 |
Business Phone Number: | 2537977431 |
Business Fax Number: | |
Mailing Address: | 24217 139th Ave Se, KENT |
State: | WA |
Postal Code: | 980425166 |
Phone Number: | 2537977431 |
Fax Number: | |
NPI Enumeration Date: | 09/29/2014 |
NPI Last Update Date: | 09/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PSYC.PY.60458583 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |