Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. TYLER R VAN WAGENEN, PA
Active Sole ProprietorMR. TYLER R VAN WAGENEN, PA is a Physician Assistant healthcare provider located in ONTARIO, Oregon. NPI 1700656352 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · ONTARIO, OR
Registration Details
- NPI Number
- 1700656352
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 4, 2024 (2.6067534412734 yrs)
- Last Updated
- Jan 14, 2026
- Licenses
-
PA219187 (OR)PA2766 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2327 SW 4TH AVEONTARIO, OR, 979141851Browse OR providers · Browse ZIP 97914
- Phone
- 5418892340
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in ONTARIO, OR
| Name | Credential | NPI |
|---|---|---|
| VICTORIA S ROGERS | PA-C | 1922106194 |
| JARED PAPA | PA-C | 1518047034 |
| JANEL WRIGHT | PA-C | 1942527908 |
| SARAH NICOLE WOOD | PA-C, MPH | 1407131733 |
| MISS AMANDA VANSANT | PA-C | 1295071496 |
| AMANDA SILUE | PA-C | 1609269190 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.