OrganizationCorvallis Psychiatry LlcPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address5441 S Macadam Ave Ste N, Portland, OR 97239(541) 351-7116PECOS EnrollmentBased on the most recent information from CMS, provider Corvallis Psychiatry Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1023995768Provider TypeOrganizationFull NameCorvallis Psychiatry LlcSubpartNoEnumeration Date8/15/2025Last Updated8/15/2025Contact InformationPractice LocationPractice Address5441 S Macadam Ave Ste N, Portland, OR 97239Phone(541) 351-7116FaxUnlisted FaxMailing LocationMailing Address5441 S Macadam Ave Ste N, Portland, OR 97239PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameFanning, Tyler (Physician)Phone(541) 351-7116Provider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerCode2084P0804XDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer