Individual
MR. TYLER WILLIAM HERNANDEZ KADELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 NE MLK BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
Mailing address
30 NE MLK BLVD, PORTLAND, OR 97232-2941
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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