Individual
PATRICK TYLER BLUETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8083 SE 13TH AVE STE 3, PORTLAND, OR 97202-6668
(971) 350-8050
Mailing address
2585 SE MARTHA CT, MILWAUKIE, OR 97222-6064
(503) 730-7478
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
R6279
OR
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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