TYLER DUANE LITTLE (NPI# 1407203144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407203144 |
| Entity Type | Individual |
| Full Name | TYLER DUANE LITTLE |
| Credential | PA-C |
| Practice Address |
1233 Edgewater St Nw Salem OR 97304-4049 |
| Practice Telephone | 5033787526 |
| Practice Fax Number | 5035885815 |
| Mailing Telephone | 5033787526 |
| Mailing Fax Number | 5035885815 |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA185298 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4311 11th Ave Ne, Suite 200, Seattle, WA 981056366 | 2066164001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538789417 | Tyler Eugene Little | Behavior Technician | 2630 W Rumble Rd, Modesto, CA 95350-0155 | 2020-04-21 |
| 1417468992 | Tyler Little | Physician Assistant | 3615 19th St, Lubbock, TX 79410-1203 | 2017-10-23 |
| 1881110864 | Tyler Little | Nurse Anesthetist, Certified Registered | 200 1st St Sw, Rochester, MN 55905-0001 | 2017-08-21 |
| Street Address |
1233 EDGEWATER ST NW |
| City | SALEM |
| State | OR |
| Zip Code | 97304-4049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306827100 | William Earle Williams | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2005-11-08 |
| 1336758630 | Ted Alas | Community Health Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2020-07-23 |
| 1245849462 | Taylor Thompson | Community Health Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2020-07-23 |
| 1063021285 | Stephanie Ochoa | Community Health Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2020-07-23 |
| 1376152603 | Kathryn Nicole Kelley | Community Health Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2020-07-22 |
| 1386280352 | Terry Denise Banta | Social Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2019-11-25 |
| 1407498074 | Jacob Benjamin Johnston | Technician | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2019-10-15 |
| 1346723038 | Erik Stephen Gillis | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2018-09-10 |
| 1215414669 | Taylor Jeanne Mcdowell | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2018-07-27 |
| 1114435807 | Elisabeth Ruth Decelles | Nurse Practitioner | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2018-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
| 1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| Find all providers in zip 97304 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285255851 | Darby Samantha Jalbert | Physician Assistant | 2480 Liberty St Ne Ste 110, Salem, OR 97301-8381 | 2020-05-05 |
| 1639614852 | Gregory Bull | Physician Assistant | 622 Fernwood Dr, Salem, VA 24153-2654 | 2016-12-24 |
| 1841648862 | Theron J Wiese | Physician Assistant | 1395 Commercial St Se, Salem, OR 97302-4205 | 2016-05-31 |
| 1922329697 | Charleen Ann Thorburn | Physician Assistant | 22 Keewaydin Dr, Salem, NH 03079-2839 | 2010-06-17 |
| 1316188006 | Judith A Mitchell | Physician Assistant | 4999 Skyline Rd. S., Salem, OR 97306 | 2009-03-10 |
| 1215912712 | Amy Gouley | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2005-12-07 |
| 1306827100 | William Earle Williams | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2005-11-08 |
| 1700485224 | Roderick Mao | Physician Assistant | 159 N Broadway, Salem, NH 03079-2136 | 2020-10-26 |
| 1447719752 | Christine Nicole Jeffries | Physician Assistant | 360 Church St Se, Salem, OR 97301-3796 | 2019-03-16 |
| 1265999338 | Brolin Johnson | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2019-02-26 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.