# TANASBOURNE FAMILY MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144383993
- **Authorized official:** DR. CRAIG GILPIN MYERS M.D. (OWNER)
- **Authorized official phone:** (503) 614-8400

## Contact information

- **Practice address:** 17200 NW CORRIDOR CT, STE 105, BEAVERTON, OR 97006-3295
- **Practice address phone:** (503) 614-8400
- **Practice address fax:** (503) 614-8411
- **Mailing address:** 17200 NW CORRIDOR CT, STE 105, BEAVERTON, OR 97006-3295
- **Mailing address phone:** (503) 614-8400
- **Mailing address fax:** (503) 614-8411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD15139 | OR | Yes |

## Other

- **Enumeration date:** 12/19/2006
- **Last updated:** 02/08/2008