IndividualActive
Tyler Stutzman, PA-C
NPI 1124448964 · Physician Assistant · Salem, OR
Provider details
- NPI number
- 1124448964
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA225085 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
890 Oak St Se Bldg a
Salem, OR 97301-3905
Phone: (503) 814-1280
Fax: (503) 814-1070
Street-level locationGet directions
Mailing address
271 Fort Richardson Ave
Goodfellow Afb, TX 76908-4901
Additional practice locations (1)
- 271 Fort Richardson AveGoodfellow Afb, TX 76908-4901Phone: (325) 654-3677
Registry dates
- Enumerated
- 2014-04-20
- Last updated
- 2025-06-15
- Certified
- 2025-06-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.