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Individual

JESSICA J TANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC, IBCLC

Contact information

Practice address
112 WARREN ST, NEWTON, MA 02459-2065
(800) 998-7042
(818) 724-7704
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-314297
OR
363LF0000X
Family Nurse Practitioner
10000143
OR

Other

Enumeration date
08/07/2022
Last updated
07/08/2025
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