Tabor, Mark

Tabor, Mark is an individual health care provider with primary practice located at 2120 Exchange St Suite 111, Astoria OR 97103-3365. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Tabor, Mark can be contacted via phone (503) 325-0333.

Contact Information

Primary practice address
2120 Exchange St Suite 111 Astoria OR 97103-3365
Phone: (503) 325-0333
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00726 Oregon

Profile Details

NPI number 1255318952
LBN Legal business name Tabor, Mark
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2005
Last updated Jul 6th, 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 1255318952 NPPES
Oregon Other 840126019 REGENCE BS/BC
Oregon Other P00087890 REGENCE BS/BC
Oregon MEDICAID 218105 REGENCE BS/BC
Oregon MEDICAID 8441354 REGENCE BS/BC

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