Individual
GARETH AUBREY TABOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27 S STATE ST, SUITE 240, LAKE OSWEGO, OR 97034-3935
(503) 636-9608
(503) 636-9600
Mailing address
27 S STATE ST, SUITE 240, LAKE OSWEGO, OR 97034-3935
(503) 636-9608
(503) 636-9600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD15143
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008859
—
OR
Enumeration date
07/04/2006
Last updated
07/08/2007
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