Individual
DR. TYLER AARON SHUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
170 MELTON RD, CRESWELL, OR 97426
(541) 895-2152
(541) 895-2215
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(503) 443-6156
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
9868PT
AZ
225100000X
Physical Therapist
Primary
62736
OR
Other
Enumeration date
07/24/2012
Last updated
08/07/2018
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