Tyler Bennink
Case Manager/Care Coordinator in Astoria, OR. Individual provider (NPI-1).
NPI number1003428640
StatusActive
Last updated in NPPESMay 6, 2025
Details
- NPI
- 1003428640
- Entity type
- Individual (NPI-1)
- Name
- Tyler Bennink
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 17, 2020
- Certification date
- May 6, 2025
- Last updated
- May 6, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
| 106S00000X | Behavior Technician | – | – | |
| 172V00000X | Community Health Worker | – | – |
Practice location
413 Gateway AveAstoria, OR 97103-6032
Phone 503-325-5722
Mailing address
65 N Highway 101 Ste 204Warrenton, OR 97146-9371
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 38 Case Manager/Care Coordinator providers in Astoria · All 683 providers in Astoria
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