Individual
TARA PFAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
36860 INDUSTRIAL WAY, SANDY, OR 97055
(503) 826-0206
Mailing address
36860 INDUSTRIAL WAY, SANDY, OR 97055-7371
(503) 826-0206
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201405290NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
DO NOT HAVE (NEED NPI TO GET MEDICAID ID)
—
Enumeration date
06/08/2017
Last updated
11/25/2019
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