ANDREW MYLES TAGLE DO
NPI 1003502303
Student in an Organized Health Care Education/Training Program in Mount Vernon, WA

Active since April 11, 2023PECOS Enrolled
819 S 13TH ST, MOUNT VERNON, WA 98274(360) 814-6230 Get Directions Write a Review

NPPES record last updated: July 10, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 10, 2023, Apr 11, 2023 (2 updates tracked since 2023).

About Andrew Myles Tagle Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREW MYLES TAGLE DO (NPI 1003502303) is an individual student in an organized health care education/training program in Mount Vernon, Washington, licensed in Washington (OL61434148) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003502303
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameANDREW MYLES TAGLECredential: DO
Location Address819 S 13TH STMount Vernon, WA 98274-4112
Mailing Address819 S 13th StMount Vernon, WA 98274-4112 · (360) 814-6230
Sole ProprietorNo
Enumeration DateApril 11, 2023
Last NPPES UpdateJuly 10, 20232 updates tracked since enumeration
NPPES CertifiedJuly 10, 2023
NPI 1003502303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
License Licensed in WA · OL61434148
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

819 S 13TH ST, Mount Vernon, WA 98274

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Andrew Myles Tagle Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
819 S 13TH ST, SRC RESIDENCY CLINIC
MOUNT VERNON, WA 98274
Student in an Organized Health Care Education/Training Program
819 S 13TH ST, CLINIC
MOUNT VERNON, WA 98274
Family Medicine
819 S 13TH ST
MOUNT VERNON, WA 98274
Family Medicine
819 S 13TH ST
MOUNT VERNON, WA 98274
Family Medicine
819 S 13TH ST
MOUNT VERNON, WA 98274
Student in an Organized Health Care Education/Training Program
819 S 13TH ST
MOUNT VERNON, WA 98274
Student in an Organized Health Care Education/Training Program
819 S 13TH ST
MOUNT VERNON, WA 98274
Family Medicine
819 S 13TH ST
MOUNT VERNON, WA 98274

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003502303, enumerated as an "individual" on April 11, 2023.

The provider is located at 819 S 13TH ST MOUNT VERNON, WA 98274 and the phone number is (360) 814-6230.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.