Individual
MR. TYLER CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., R.D., L.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8795
Mailing address
52084 SW EGGLESTON LN, SCAPPOOSE, OR 97056-2619
(541) 973-8569
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10209316
OR
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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