Gluckman, Tyler Justin

Gluckman, Tyler Justin is an individual health care provider with primary practice located at 9427 Sw Barnes Rd Suite 498, Portland OR 97225-6652. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Gluckman, Tyler Justin can be contacted via phone (503) 216-0900.

Contact Information

Primary practice address
9427 Sw Barnes Rd Suite 498 Portland OR 97225-6652
Phone: (503) 216-0900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X D0058894 Maryland
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD26695 Oregon

Profile Details

NPI number 1790749422
LBN Legal business name Gluckman, Tyler Justin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2006
Last updated Dec 18th, 2012 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1790749422 NPPES
Oregon MEDICAID 240072
Oregon Other P00848623
Oregon Other P00348434

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