Provider Demographics
NPI:1033909726
Name:LOYOLA, NYLIAM DORYVETTE (MS)
Entity type:Individual
Prefix:MISS
First Name:NYLIAM
Middle Name:DORYVETTE
Last Name:LOYOLA
Suffix:
Gender:
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. SAGRADO CORAZON CALLE SANTA LUCIA, #25
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653
Mailing Address - Country:US
Mailing Address - Phone:787-532-7029
Mailing Address - Fax:787-532-7029
Practice Address - Street 1:812 SW WASHINGTON ST STE 700
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3200
Practice Address - Country:US
Practice Address - Phone:503-622-8964
Practice Address - Fax:503-622-8964
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program