Thompson, Tara Rae
Thompson, Tara Rae is an individual health care provider with primary practice located at 1698 E Mcandrews Rd Ste 400 , Medford OR 97504-5590. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Thompson, Tara Rae can be contacted via phone (541) 732-7400.Contact Information
Primary practice address
1698 E Mcandrews Rd Ste 400
Medford OR 97504-5590
Phone: (541) 732-7400
Fax: (541) 732-3410
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | AP 07195 | Louisiana |
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | AP61501809 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | 10018842APRN-NP | Oregon |
Profile Details
| NPI number | 1710226204 |
|---|---|
| LBN Legal business name | Thompson, Tara Rae |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 4th, 2013 |
| Last updated | Mar 12th, 2024 - about 2 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 | 1710226204 | NPPES |
| Oregon | Other | 10018842 | OREGON BOARD OF NURSING |
| Oregon | Other | PA 080109 | OREGON BOARD OF NURSING |
| Oregon | MEDICAID | 2337483 | OREGON BOARD OF NURSING |
| Oregon | Other | AP61501809 | OREGON BOARD OF NURSING |
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