Individual
TAMI SUE MARRIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2700 NW STEWART PKWY, ROSEBURG, OR 97471-1281
(541) 677-4333
Mailing address
2100 POWELL ST, STE 900, EMERYVILLE, CA 94608-1844
(510) 851-7423
(510) 879-9120
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD27684
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000038219
ANTHEM
OH
05
—
2105886
—
OH
05
—
214021
—
OR
05
—
311397603026
—
OH
Enumeration date
04/11/2006
Last updated
02/25/2017
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