Provider Demographics
NPI:1689242158
Name:WUTHMANN, TYLER THOMAS (ND)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:THOMAS
Last Name:WUTHMANN
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 MIDDLEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-3000
Mailing Address - Country:US
Mailing Address - Phone:650-485-2758
Mailing Address - Fax:
Practice Address - Street 1:3200 MIDDLEFIELD RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-3000
Practice Address - Country:US
Practice Address - Phone:650-485-2758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath