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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508830571 | NPPES |
| Idaho | MEDICAID | 806098000 |
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