Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ty C. Gulstrom, PA-C

Individual provider Emergency Medicine Physician · NPI 1558306373

Ty C. Gulstrom, PA-C is an Emergency Medicine Physician in Mount Vernon, Washington. Licensed in Washington. Registered with an NPI since 2006.

Licensed in
WA
In the registry since
2006
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone: (360) 428-6434
Fax: (360) 848-4233
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA10004348 (WA)
Emergency Medicine Physician Taxonomy 207P00000X · Licence PA10004348 (WA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA10004348 (WA)

Record details

NPI number1558306373
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 17, 2006
Last updated in NPPESFebruary 18, 2015

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