Haynes, Tana Marie

Haynes, Tana Marie is an individual health care provider with primary practice located at 19260 Sw 65Th Ave Ste 270 Suite B2, Tualatin OR 97062-5705. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Haynes, Tana Marie can be contacted via phone (503) 699-0764.

Contact Information

Primary practice address
19260 Sw 65Th Ave Ste 270 Suite B2 Tualatin OR 97062-5705
Phone: (503) 699-0764
Fax: (503) 329-1851
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD24660 Oregon

Profile Details

NPI number 1639160369
LBN Legal business name Haynes, Tana Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Jun 25th, 2013 - about 13 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 1639160369 NPPES
Oregon MEDICAID 029123

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