Individual
TYLER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
815 NE HALSEY ST STE B, PORTLAND, OR 97232-1219
(814) 882-2328
Mailing address
4925 SE SHERMAN ST, PORTLAND, OR 97215-3850
(814) 882-2328
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6202
OR
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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