Gardner-Brown, Tara

Gardner-Brown, Tara is an individual health care provider with primary practice located at 1880 Sw 6Th Ave Ste 200 Portland State University, Portland OR 97201-5204. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gardner-Brown, Tara can be contacted via phone (503) 725-2800.

Contact Information

Primary practice address
1880 Sw 6Th Ave Ste 200 Portland State University Portland OR 97201-5204
Phone: (503) 725-2800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 201250044NP Oregon

Profile Details

NPI number 1508830571
LBN Legal business name Gardner-Brown, Tara
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Jun 20th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508830571 NPPES
Idaho MEDICAID 806098000

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