MR. Tyler R Van Wagenen, PA
NPI #1700656352 in Ontario, Oregon
Provider Information
- NPI Number
- 1700656352
- Entity Type
- Individual
- Name
- MR. Tyler R Van Wagenen, PA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Credential
- PA
- Enumeration Date
- Jan 4, 2024
- Last Updated
- Jan 14, 2026
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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