Tyler-Jimenez, Elizabeth Nicole

Tyler-Jimenez, Elizabeth Nicole is an sole proprietor health care provider with primary practice located at 929 Nw Grant Ave , Corvallis OR 97330-4503. She recently has only one registered license in Student, Health Care / Student in an Organized Health Care Education/Training Program, which is considered as her primary health care specialty. Tyler-Jimenez, Elizabeth Nicole can be contacted via phone (541) 754-1023.

Contact Information

Primary practice address
929 Nw Grant Ave Corvallis OR 97330-4503
Phone: (541) 754-1023
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1295057644
LBN Legal business name Tyler-Jimenez, Elizabeth Nicole
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 25th, 2010
Last updated Feb 25th, 2010 - about 15 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 1295057644 NPPES
Oregon MEDICAID BL100U3L

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