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Individual

TANNER JOHN BARLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
1610 C ST, SUITE 103, VANCOUVER, WA 98663-3400
(360) 694-0300
Mailing address
1610 C ST, SUITE 103, VANCOUVER, WA 98663-3400
(360) 694-0300

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Enumeration date
04/18/2012
Last updated
04/18/2012
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