Individual
KYLE TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4103 MERCANTILE DR, LAKE OSWEGO, OR 97035-2556
(503) 850-9940
Mailing address
4103 MERCANTILE DR, LAKE OSWEGO, OR 97035-2556
(503) 850-9940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA227148
OR
Other
Enumeration date
10/23/2025
Last updated
10/23/2025
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