Organization
TANASBOURNE PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAQUEL MARIE APODACA (OWNER)
(503) 690-8195
Entity
Organization
Contact information
Practice address
17895 NW EVERGREEN PKWY STE 110, BEAVERTON, OR 97006-7402
(503) 690-8195
(503) 629-5806
Mailing address
17895 NW EVERGREEN PKWY STE 110, BEAVERTON, OR 97006-7402
(503) 690-8195
(503) 629-5806
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD21108
OR
Other
Enumeration date
06/25/2007
Last updated
05/12/2026
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