Individual
MRS. MIRANDA TASKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
636 11TH AVE SW, ALBANY, OR 97321-2506
(619) 642-8256
Mailing address
636 11TH AVE SW, ALBANY, OR 97321-2506
(619) 642-8256
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
THW000104271
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW000104271
TRADITIONAL HEALTH WORKER - DOULA
OR
Enumeration date
10/20/2020
Last updated
10/20/2020
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