Organization
CORVALLIS PSYCHIATRY LLC
Active
Organization
CORVALLIS PSYCHIATRY LLC
Active
Other names
Corvallis Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER FANNING MD (PHYSICIAN)
(541) 351-7116
Entity
Organization
Contact information
Practice address
5441 S MACADAM AVE STE N, PORTLAND, OR 97239
(541) 351-7116
Mailing address
5441 S MACADAM AVE STE N, PORTLAND, OR 97239
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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