Individual
TINAH ADELE BAZIN-QUINTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
7754 SW CAPITOL HWY, PORTLAND, OR 97219-2592
(503) 977-0733
Mailing address
7754 SW CAPITOL HWY, PORTLAND, OR 97219-2592
(503) 977-0733
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200750151NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0374215-22
ANCC CERT NUMBER
—
01
—
200750151NP
OREGON NP LICENSE
OR
Enumeration date
12/18/2006
Last updated
03/07/2023
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