Individual
MR. TYLER KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5701 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3195
(503) 244-1107
Mailing address
4000 DUNWOODY PARK, APT 5207, DUNWOODY, GA 30338-7950
(503) 810-3223
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
T09280
OR
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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