Individual
TYLER CLARK CHIPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
600 NE 8TH ST STE 300, GRESHAM, OR 97030-7318
(503) 988-5155
(503) 988-5185
Mailing address
2942 SE YAMHILL ST APT A, PORTLAND, OR 97214-4092
(503) 593-9521
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201506224NP-PP
OR
Other
Enumeration date
10/02/2015
Last updated
10/02/2015
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