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Individual

DR. JOHN TYLER THIESING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-4830
Mailing address
PO BOX 25184, PORTLAND, OR 97298-0184
(503) 292-9108

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD27230
OR
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD27230
OR

Other

Enumeration date
11/28/2006
Last updated
04/28/2025
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