Individual
TYLER JAMES BOULANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4212 SE DIVISION ST, PORTLAND, OR 97206-1680
(503) 238-0705
(503) 236-7166
Mailing address
4212 SE DIVISION ST, PORTLAND, OR 97206-1680
(503) 238-0705
(503) 236-7166
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
10/29/2020
Last updated
08/21/2022
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