Provider Demographics
NPI:1346882966
Name:DEARING, TYLER (PHARMD)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:DEARING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MYRTLE CREEK
Mailing Address - State:OR
Mailing Address - Zip Code:97457-9334
Mailing Address - Country:US
Mailing Address - Phone:541-891-1210
Mailing Address - Fax:
Practice Address - Street 1:821 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MYRTLE CREEK
Practice Address - State:OR
Practice Address - Zip Code:97457-9334
Practice Address - Country:US
Practice Address - Phone:541-391-8321
Practice Address - Fax:541-391-8381
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH00175621835P0018X
ORRPH-0017562183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist