TYLER FREEDELL NELSON (NPI# 1821587056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821587056 |
| Entity Type | Individual |
| Full Name | TYLER FREEDELL NELSON |
| Credential | MD |
| Practice Address |
4104 Se 82nd Ave Ste 250 Portland OR 97266-2954 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032159850 |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-05-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | PG188838 | OR | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740778158 | Tyler Nelson | Specialist/Technologist | 11501 30 Hwy Sw, Hayfield, MN 55940-8602 | 2018-05-01 |
| 1396159885 | Tyler Leroy Nelson | Chiropractor | 1951 W 4700 S Ste 2, Taylorsville, UT 84129-1108 | 2014-06-12 |
| 1184860561 | Tyler Elliott Nelson | Dentist | 2801 Waterman Blvd Ste 240, Fairfield, CA 94534-2987 | 2009-01-06 |
| 1740394865 | Tyler Scott Nelson | Chiropractor | 5434 Yadkin Rd, Fayetteville, NC 28303-3199 | 2006-08-18 |
| 1770104069 | Tyler Nelson | Optometrist | 1011 Honor Heights Dr, Muskogee, OK 74401-1318 | 2020-04-28 |
| 1558900159 | Tyler G Nelson | Nurse Anesthetist, Certified Registered | 15790 Paul Vega Md Dr, Hammond, LA 70403-1436 | 2019-12-30 |
| 1336701648 | Tyler Nelson | Case Manager/Care Coordinator | 120 S Barstow St, Eau Claire, WI 54701-3642 | 2019-07-08 |
| 1801381892 | Tyler Merrill Nelson | Dentist | 378 E 400 S Ste 1, Springville, UT 84663-1981 | 2018-06-22 |
| 1790093599 | Tyler E Nelson | Dentist | 1411 E 31st St, Department of Oral and Maxillofacial Surgery, Oakland, CA 94602-1018 | 2010-09-15 |
| 1477860385 | Tyler Scott Nelson | Physician Assistant | 50 N Medical Dr, Salt Lake City, UT 84132-1100 | 2010-09-13 |
| Street Address |
4104 SE 82ND AVE STE 250 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97266-2954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073856142 | Ben Lawrence Pederson | Family Medicine | 4104 Se 82nd Ave Ste 250, Portland, OR 97266-2954 | 2013-03-27 |
| 1518587575 | Triet Anh Nguyen | Student in an Organized Health Care Education/Training Program | 4104 Se 82nd Ave Ste 250, Portland, OR 97266-2954 | 2020-04-20 |
| 1326668385 | Bao Tran Nhan | Student in an Organized Health Care Education/Training Program | 4104 Se 82nd Ave Ste 250, Portland, OR 97266-2954 | 2020-04-20 |
| 1598329328 | Michael Robert Dirks Jr. | Student in an Organized Health Care Education/Training Program | 4104 Se 82nd Ave Ste 250, Portland, OR 97266-2954 | 2019-04-26 |
| 1851955785 | Katherine E Cobb | Student in an Organized Health Care Education/Training Program | 4104 Se 82nd Ave Ste 250, Portland, OR 97266-2954 | 2019-04-25 |
| 1922662857 | Hannah Kadavy | Student in an Organized Health Care Education/Training Program | 4104 Se 82nd Ave Ste 250, Portland, OR 97266-2954 | 2019-04-25 |
| 1598254898 | Elizabeth Belen Deyo | Student in an Organized Health Care Education/Training Program | 4104 Se 82nd Ave Ste 250, Portland, OR 97266-2954 | 2018-05-02 |
| 1598261372 | Rachel Alina Boneski | Student in an Organized Health Care Education/Training Program | 4104 Se 82nd Ave Ste 250, Portland, OR 97266-2954 | 2018-04-02 |
| 1295187367 | Nicholas T Wolfgang | Student in an Organized Health Care Education/Training Program | 4104 Se 82nd Ave Ste 250, Portland, OR 97266-2954 | 2016-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528545969 | Willamette Pharmacy | Pharmacy | 10209 Se Division Build B Ste 100, Portland, OR 97266 | 2018-07-27 |
| 1992204697 | Sober Living Oregon Treatment Center | Clinic/Center | 10209 Se Division, Portland, OR 97266 | 2018-02-08 |
| 1699204024 | Malori Christine Butler | Registered Nurse | 7335 Se 85th Ave., Portland, OR 97266 | 2017-06-08 |
| 1487028882 | Emil Kunkel | Naturopath | 6318 Se 87th Ave, Portland, OR 97266 | 2015-11-23 |
| 1194195313 | Cory Hall-martin | Counselor | 10011 Se Division St #305, Portland, OR 97266 | 2015-09-30 |
| 1336517721 | Krispin Mayfield | Counselor | 10011 Se Division St., Suite 203, Portland, OR 97266 | 2015-09-02 |
| 1407247927 | Syrena Nicholson | Community Health Worker | 7721 Se 92nd Avenue, Apt K, Portland, OR 97266 | 2015-02-06 |
| 1659777886 | Berhanu Aynalem Mekbib | Adult Companion | 9125 Sw 55th, El Dorado, Portland, OR 97266 | 2014-11-17 |
| 1871930685 | Felicitas Amelia Penaloza | Behavioral Analyst | 9911 Se Mt.scott Boulevard, Portland, OR 97266 | 2013-06-03 |
| 1710237326 | Janna Renee Higgins | Case Manager/Care Coordinator | 9911 Se Mt. Scott Boulevard, Portland, OR 97266 | 2012-09-12 |
| Find all providers in zip 97266 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536602 | Dario J Lapoma | Student in an Organized Health Care Education/Training Program | 1305 Se Birch St, Portland, OR 97214-5335 | 2020-10-18 |
| 1740888155 | Charles Samuel Goldfoot | Student in an Organized Health Care Education/Training Program | 1650 Nw 13th Ave Apt 109, Portland, OR 97209-3694 | 2020-10-16 |
| 1396343992 | Shelby Taylor Bowerly | Student in an Organized Health Care Education/Training Program | 4522 Ne Ainsworth St, Portland, OR 97218-1322 | 2020-10-15 |
| 1821696816 | Nancy Sierra Ferrer | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd # Or97239, Portland, OR 97239-3011 | 2020-10-13 |
| 1437757663 | David Gallacher | Student in an Organized Health Care Education/Training Program | 3303 S Bond Ave # 1, Portland, OR 97239-4501 | 2020-10-10 |
| 1366049777 | Carolyn Evans | Student in an Organized Health Care Education/Training Program | 80 Ne 14th Ave Apt 314, Portland, OR 97232-3568 | 2020-10-08 |
| 1669081659 | Amy Hill | Student in an Organized Health Care Education/Training Program | 3931 N Juneau St Apt 7, Portland, OR 97217-7419 | 2020-07-27 |
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1558986364 | Haley Bosco Doyle | Student in an Organized Health Care Education/Training Program | 3587 Se Grant St, Portland, OR 97214-5829 | 2020-06-08 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.