Individual
BARRY TANNE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
403 S GRANITE AVE, GRANITE FALLS, WA 98252
(360) 691-7711
(360) 691-7864
Mailing address
PO BOX 1650, 403 S GRANITE AVE, GRANITE FALLS, WA 98252-1650
(360) 691-7711
(360) 691-7864
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00017729
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1057967
—
WA
Enumeration date
04/18/2006
Last updated
07/08/2007
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