Tyler, Mary Elizabeth

Tyler, Mary Elizabeth is an individual health care provider with primary practice located at 2801 N Gantenbein Ave , Portland OR 97227-1623. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Tyler, Mary Elizabeth can be contacted via phone (503) 413-2119.

Contact Information

Primary practice address
2801 N Gantenbein Ave Portland OR 97227-1623
Phone: (503) 413-2119
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 077039059N9 NNP-PP Oregon

Profile Details

NPI number 1447214465
LBN Legal business name Tyler, Mary Elizabeth
Credentials NNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Nov 21st, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447214465 NPPES
Oregon MEDICAID 022938

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