OrganizationActive
Corvallis Psychiatry LLC
NPI 1023995768 · Psychiatry Physician · Portland, OR
Provider details
- NPI number
- 1023995768
- Entity type
- Organization
- Primary specialty
- Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tyler Fanning, Physician(541) 351-7116
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Child & Adolescent Psychiatry Physician2084P0804X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5441 S Macadam Ave Ste N
Portland, OR 97239
Phone: (541) 351-7116
Approximate (ZIP-level) locationGet directions
Mailing address
5441 S Macadam Ave Ste N
Portland, OR 97239
Other names (DBA / former)
- Other name
- Corvallis Psychiatry
Registry dates
- Enumerated
- 2025-08-15
- Last updated
- 2025-08-15
- Certified
- 2025-08-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.