IndividualActive
Susan Tyler, CBS, DIPLOMATE, CNC
NPI 1194050831 · Specialist · Glide, OR
Provider details
- NPI number
- 1194050831
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Credential
- CBS, DIPLOMATE, CNC
- Sex
- Female
- Sole proprietor
- No
- License
- CERTIFICATION ONLY (CA)
Specialties & taxonomies
Other Service Providers
Dietary & Nutritional Service Providers
Other Service Providers
Other Service Providers
Practice location
268 New Bridge Rd
Glide, OR 97443-9609
Phone: (541) 733-4207
Fax: (888) 629-4949
Approximate (ZIP-level) locationGet directions
Mailing address
268 New Bridge Rd
Glide, OR 97443-9609
Registry dates
- Enumerated
- 2009-10-14
- Last updated
- 2009-10-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.