Active NPI
Tyler Casey
- Psychiatric Pharmacist
- Clackamas, OR
National Provider Identifier
1548733017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 0016014
- Practice address
- 10163 SE Sunnyside Rd Ste 490
Clackamas, OR 97015-5720 - Phone
- (503) 513-7406
- NPI assigned
- Jan 8, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | 0016014 | OR | Primary |
Addresses
Primary practice location
10163 SE Sunnyside Rd Ste 490
Clackamas, OR 97015-5720
Mailing address
2119 NE 14TH Ave Apt 4
Portland, OR 97212-4359
Phone (859) 321-4707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0016014 | OR | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546905600000",
"number": "1548733017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2119 NE 14TH AVE APT 4",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972124359",
"telephone_number": "859-321-4707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10163 SE SUNNYSIDE RD STE 490",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970155720",
"telephone_number": "503-513-7406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASEY",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-08",
"last_updated": "2019-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "OR",
"license": "0016014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.