Organization
PORTLAND PSYCHIATRIC ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER CHIPMAN DNP (MEMBER)
(503) 406-6515
Entity
Organization
Contact information
Practice address
3434 SW KELLY AVE, PORTLAND, OR 97239-4630
(503) 406-6515
Mailing address
3434 SW KELLY AVE, PORTLAND, OR 97239-4630
(503) 406-6515
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/26/2019
Last updated
11/26/2019
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