Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gavin Tyler Tanis, MS, LAT, ATC

Individual provider Athletic Trainer · NPI 1205660263

Gavin Tyler Tanis, MS, LAT, ATC is an Athletic Trainer in Lewiston, Maine. Licensed in Maine. Registered with an NPI since 2024.

Licensed in
ME
In the registry since
2024
What do these letters mean?
MS — Master of Science
A graduate science degree.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

141 Russell St
Lewiston, ME 04240-6024
Phone: (207) 786-6255
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT970 (ME)

Record details

NPI number1205660263
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , LAT , ATC
Sole proprietorNo
NPI enumeratedAugust 30, 2024
Last updated in NPPESAugust 30, 2024
Certification dateAugust 30, 2024

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