Individual
DR. STEVEN CHARLES TACKETT-NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
821 SAGINAW STREET S, SALEM, OR 97302
(503) 362-1999
(503) 362-9671
Mailing address
821 SAGINAW STREET S, SALEM, OR 97302
(503) 362-1999
(503) 362-9671
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD15455
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A006
TRICARE
—
Enumeration date
10/02/2006
Last updated
07/08/2007
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