Provider Demographics
NPI:1730555335
Name:LEWIS-DAHM, TYLER
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:LEWIS-DAHM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14715 W 64TH AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3544
Mailing Address - Country:US
Mailing Address - Phone:303-456-5858
Mailing Address - Fax:
Practice Address - Street 1:14715 W 64TH AVE
Practice Address - Street 2:SUITE H
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3544
Practice Address - Country:US
Practice Address - Phone:303-456-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator