Individual
DR. THOMAS W LYTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1960 NW 167TH PL, SUITE 200, BEAVERTON, OR 97006-4803
(503) 672-6085
(503) 672-6081
Mailing address
1960 NW 167TH PL, SUITE 200, BEAVERTON, OR 97006-4803
(503) 672-6085
(503) 672-6081
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05441
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05441
OREGON STATE LICENSE
OR
05
—
PENDING
—
OR
Enumeration date
12/01/2009
Last updated
01/14/2014
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