Tyler Laurent, CSFA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

740 Main St
Fairview, OR 97024-1909

Phone

(971) 678-2298

NPI assigned

Jan 20, 2022

Last updated

Jan 22, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• PNW Surgical Assisting LLC

  • Surgical Physician Assistant
  • Tigard, OR
  • NPI 1427700798
  NPD Authorized official

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642809600000",
    "number": "1841942927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 MAIN ST",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970241909",
            "telephone_number": "971-678-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MAIN ST",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970241909",
            "telephone_number": "971-678-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENT",
        "first_name": "TYLER",
        "credential": "CSFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-22",
        "certification_date": "2022-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "OR",
            "license": "204464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Kuhn
• Brent Labhart
• Laroy Lackey
• Angela Lafontaine
• Stephanie Joan Larson
• Linda Laws
• Karen Lee
• Edna Leed
• Crystal Shan Lei, PHARMD
• Rebecca Leibham

• Surgical Physician Assistant in Fairview, OR
• Providers in Fairview, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2022; 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.