Individual
SEAN TYLER WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5050 NE HOYT ST STE 651, PORTLAND, OR 97213
(503) 935-8700
(503) 935-8701
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD187475
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2028353
—
WA
05
—
500704186
—
OR
Enumeration date
04/15/2013
Last updated
12/04/2025
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