Tyler Clark Chipman, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201506224NP-PP Issued in OR

Practice address

600 NE 8TH St Ste 300
Gresham, OR 97030-7318

Phone

(503) 988-5155

Fax

(503) 988-5185

NPI assigned

Oct 2, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Multnomah County

  • Federally Qualified Health Center (FQHC)
  • Gresham, OR
  • NPI 1518005693
  NPD (past)

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1366812372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2942 SE YAMHILL ST APT A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144092",
            "telephone_number": "503-593-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE 8TH ST STE 300",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307318",
            "telephone_number": "503-988-5155",
            "fax_number": "503-988-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIPMAN",
        "first_name": "TYLER",
        "middle_name": "CLARK",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-02",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201506224NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl C. Tidball DO PC
• Chestnut Lane Operations LLC
• Melissa E Childs
• Cheri Dodge Chin, CLINSCD, CCC/SLP
• Marc Francis Chinard, MS, LCSW
• Ann Chiu
• James Sok Chong, DO
• Stephen K. Choong, M.D.
• Kristan Chow
• May-Lynn Chu, D.O

• Psychiatric/Mental Health Nurse Practitioner in Gresham, OR
• Providers in Gresham, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.