Healthcare Provider Details

I. General information

NPI: 1730066259
Provider Name (Legal Business Name): TYLER HOANG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 NE BROADWAY ST STE 245
PORTLAND OR
97232-1128
US

IV. Provider business mailing address

18621 SE ASHTON LN
MILWAUKIE OR
97267-6702
US

V. Phone/Fax

Practice location:
  • Phone: 503-432-1061
  • Fax:
Mailing address:
  • Phone: 503-616-6263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR.CH.70019623
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: