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Individual

TYE SOUTHERN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
2455 SE LARKSPUR CT, HILLSBORO, OR 97123-8332
(503) 648-7148
Mailing address
2455 SE LARKSPUR CT, HILLSBORO, OR 97123-8332
(503) 648-7148

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
OR

Other

Enumeration date
11/28/2006
Last updated
07/08/2007
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