Provider Demographics
NPI:1679846216
Name:FLAMING, TYLER PAUL (RPH)
Entity Type:Individual
Prefix:MR
First Name:TYLER
Middle Name:PAUL
Last Name:FLAMING
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 NW CONKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1203
Mailing Address - Country:US
Mailing Address - Phone:541-476-8224
Mailing Address - Fax:541-476-4132
Practice Address - Street 1:1204 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1254
Practice Address - Country:US
Practice Address - Phone:541-476-8224
Practice Address - Fax:541-476-4132
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH0007683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist