Provider Demographics
NPI:1558732933
Name:TYLER, LASHELLE
Entity Type:Individual
Prefix:MISS
First Name:LASHELLE
Middle Name:
Last Name:TYLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 NE 91ST AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-5757
Mailing Address - Country:US
Mailing Address - Phone:971-720-2560
Mailing Address - Fax:
Practice Address - Street 1:912 NE 91ST AVE APT 7
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-5757
Practice Address - Country:US
Practice Address - Phone:971-720-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide