Individual
TYLER TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 S 5TH ST STE 140, SPRINGFIELD, OR 97477-5480
(541) 625-0191
Mailing address
224 W 37TH AVE, EUGENE, OR 97405-3312
(541) 263-9993
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
22642
MA
225100000X
Physical Therapist
Primary
61867
OR
Other
Enumeration date
08/10/2016
Last updated
03/20/2021
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