IndividualActive
Tyler Larson, PA-C
NPI 1003211103 · Physician Assistant · Sweet Home, OR
Provider details
- NPI number
- 1003211103
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 10001988A (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1289 49th Ave
Sweet Home, OR 97386
Phone: (541) 451-6250
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1189
Corvallis, OR 97339-1189
Registry dates
- Enumerated
- 2014-10-31
- Last updated
- 2023-11-27
- Certified
- 2023-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.