Individual
TYLER CASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10163 SE SUNNYSIDE RD STE 490, CLACKAMAS, OR 97015-5720
(503) 513-7406
Mailing address
2119 NE 14TH AVE APT 4, PORTLAND, OR 97212-4359
(859) 321-4707
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
0016014
OR
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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