Boulter, Tyler Dallin

Boulter, Tyler Dallin is an individual health care provider with primary practice located at 9135 Sw Barnes Rd Ste 961 , Portland OR 97225-6699. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Boulter, Tyler Dallin can be contacted via phone (503) 292-0848.

Contact Information

Primary practice address
9135 Sw Barnes Rd Ste 961 Portland OR 97225-6699
Phone: (503) 292-0848
Fax: (503) 296-0635
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 22178 New Hampshire
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD215593 Oregon

Profile Details

NPI number 1730683970
LBN Legal business name Boulter, Tyler Dallin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2018
Last updated Jun 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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