Corvallis Psychiatry LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

CORVALLIS PSYCHIATRY LLC

Practice address

5441 S Macadam Ave Ste N
Portland, OR 97239

Phone

(541) 351-7116

NPI assigned

Aug 15, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tyler Fanning, MDNPI 1760987473

Title

Physician

Phone

(541) 351-7116

Specialties & licenses 2

Addresses

Other names 1

• Corvallis Psychiatry Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyler Fanning, MD

  • Psychiatry Physician
  • Corvallis, OR
  • NPI 1760987473
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1023995768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "541-351-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORVALLIS PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "FANNING",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "541-351-7116",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corvallis Psychiatry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alondra Cortes
• Cortez Natural Medicine, Inc.
• Alice Cortez
• Francisco Soliz Cortez
• Michael Anthony Cortez, MSW
• Jill Corvelli, LPC, CADC, CGAC
• Elizabeth Rachel Corwin, MD
• Jan Corwin, DC
• Tiffany Corwin, MA, LPC
• Cynthia Diane Cory, LAC

• Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.