Individual
LORI TAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9427 SW BARNES RD, SUITE 498, PORTLAND, OR 97225-6652
(503) 216-0900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD159837
OR
207RC0000X
Cardiovascular Disease Physician
MD60400519
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500657817
—
OR
01
—
P01247406
PHS- RAILROAD MEDICARE - OREGON
OR
01
—
P01388724
PHS - RAILROAD MEDICARE - WA
WA
Enumeration date
07/27/2007
Last updated
10/19/2020
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