Packer, Tiara F

Packer, Tiara F is an individual health care provider with primary practice located at 3620 Nw Samaritan Drive Suite 202, Corvallis OR 97330. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Packer, Tiara F can be contacted via phone (541) 768-4810.

Contact Information

Primary practice address
3620 Nw Samaritan Drive Suite 202 Corvallis OR 97330
Phone: (541) 768-4810
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 0614 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA130018 Oregon

Profile Details

NPI number 1447313010
LBN Legal business name Packer, Tiara F
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2006
Last updated Sep 24th, 2010 - about 16 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 1447313010 NPPES
New Hampshire Other 01Y005045NH03 ANTHEM BCBS MOA
New Hampshire MEDICAID 30334821 ANTHEM BCBS MOA
New Hampshire Other 01Y005045NH02 ANTHEM BCBS MOA

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