Individual
TYLER BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3925 SW 153RD DR STE 210, BEAVERTON, OR 97003-4176
(971) 727-8155
Mailing address
3925 SW 153RD DR STE 210, BEAVERTON, OR 97003-4176
(971) 727-8155
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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