Individual
TYLER NAGAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12518 NE AIRPORT WAY STE 110, PORTLAND, OR 97230-1090
(503) 256-2992
Mailing address
1514 NE MARINE DR, PORTLAND, OR 97211-1532
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
64978
OR
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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