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Organization

GARETH A. TABOR M.D., P.C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JANET TABOR (OFFICE MANAGER)
(503) 636-9608
Entity
Organization

Contact information

Practice address
27 S STATE ST, #240, LAKE OSWEGO, OR 97034-3935
(503) 636-9608
(503) 636-9600
Mailing address
27 S STATE ST, #240, LAKE OSWEGO, OR 97034-3935
(503) 636-9608
(503) 636-9600

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15143
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008859
OR
01
1205866399
NPI FOR DR. TABOR
OR
Enumeration date
11/08/2007
Last updated
10/09/2012
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