Individual
TARA BEATTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6103 SE RHONE ST, PORTLAND, OR 97206-2871
(503) 724-3104
Mailing address
6103 SE RHONE ST, PORTLAND, OR 97206-2871
(503) 724-3104
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201406596RN
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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