NPI 1003366808

Tyler J Light

Practitioner Student in an Organized Health Care Education/Training Program Corvallis, OR

Practice location

Address: 444 NW Elks Dr, Corvallis, OR 97330-3758
Phone: (503) 494-8311
Mailing address: 444 NW Elks Dr, Corvallis, OR 97330-3745

Registered specialties (2)

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

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Otolaryngology Physician

Allopathic & Osteopathic Physicians Taxonomy 207Y00000X Licence MD208155 (OR)

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Registry record

NPI: 1003366808
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Oct 2016
Record last updated: 23 May 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.