Individual
DR. TAMMY LEE BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2525 NE 139TH ST STE 220, VANCOUVER, WA 98686-2719
(360) 397-4437
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 397-4040
(360) 604-1770
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
37480-020
WI
208800000X
Urology Physician
Primary
MD60525316
WA
Other
Enumeration date
03/24/2006
Last updated
04/04/2023
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