Individual
TABITHA M GHOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2222 NW LOVEJOY ST STE 505, PORTLAND, OR 97210-5103
(971) 432-7555
Mailing address
121 LEONARD ST APT A, LAKE OSWEGO, OR 97034-3953
(503) 502-4409
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F10230923
OR
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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