Kirkpatrick Graham, Tara S.

Kirkpatrick Graham, Tara S. is an individual health care provider with primary practice located at 2801 N Gantenbein Ave , Portland OR 97227-1623. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Kirkpatrick Graham, Tara S. can be contacted via phone (503) 413-1867.

Contact Information

Primary practice address
2801 N Gantenbein Ave Portland OR 97227-1623
Phone: (503) 413-1867
Fax: (503) 413-2580
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 200650152NP Oregon

Profile Details

NPI number 1740407683
LBN Legal business name Kirkpatrick Graham, Tara S.
Credentials NNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Jun 26th, 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 1740407683 NPPES
Oregon MEDICAID 271141

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