Individual
TYLER MARCUS ANDREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3615 NW SAMARITAN DR STE 203, CORVALLIS, OR 97330-3771
(541) 768-6930
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO212958
OR
207RN0300X
Nephrology Physician
Primary
DO212958
OR
207RN0300X
Nephrology Physician
OS021030
PA
Other
Enumeration date
05/31/2016
Last updated
08/29/2023
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