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General NPI Number Information
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NPI Number | 1629855408
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Entity Type | Individual
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Provider Name | TYLER KAI
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Gender | Male
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 190 SE 8TH AVE
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City | HILLSBORO
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State | OR
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Zip | 97123-4216
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Country | US
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Telephone | 503-352-7224
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Fax |
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Provider Business Mailing Address
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Address Line | 8585 CRITERION DR # 62094
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-1045
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0008163
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License Number State | CO
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