Tanya R Wormdahl LMT

NPI 1255501805 - Specialist - 174400000X

NPI Details
NPI 1255501805
Gender Female
Enumeration Date 03/10/2008
Last Updated 03/10/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
5553 NE GLISAN ST
300
PORTLAND OR, 97213-3173, US
Phone (503) 757-3878
Fax
Business Location
5553 NE GLISAN ST
300
PORTLAND OR, 97213-3173, US
Phone (503) 757-3878
Fax
Toxanomy
Taxonomy Code 174400000X
License State Oregon
License Number 11215
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According to our database, Mrs. Tanya R Wormdahl LMT NPI is 1255501805, taxonomy code is 174400000X and license number is 11215, license state is located at Oregon. Tanya R Wormdahl LMT physically located at 5553 Ne Glisan St, Portland OR, 97213-3173. NPI Number Tanya R Wormdahl LMT has the Individual type.

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1255501805 NPI number is provided on an as is basis without warranty of any kind. 1255501805 is maintained by the National Plan & Provider Enumeration System. The contents of Tanya R Wormdahl LMT are for informational purposes only.