Individual
MR. TYRELL ANTHONY COMEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RD
Contact information
Practice address
24800 SE STARK ST, GRESHAM, OR 97030-3378
(503) 674-1275
Mailing address
14030 SW BURLWOOD LN, BEAVERTON, OR 97005-2362
(503) 707-6164
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10178292
OR
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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