Individual
MR. ANDRE KEITH TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
914 NW 13TH AVE, PORTLAND, OR 97209-3039
(971) 244-9000
(971) 244-9005
Mailing address
1248 SE PINE ST, PORTLAND, OR 97214-1432
(913) 710-6467
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5285
OR
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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