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Individual

MR. RONALD TATUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BA

Contact information

Practice address
22018 S CENTRAL POINT RD, CANBY, OR 97013-8705
(503) 221-4531
(503) 221-4531
Mailing address
17435 SW BLANTON ST, ALOHA, OR 97078-1340
(503) 332-9112
(503) 263-6278

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500606514
OR
Enumeration date
02/26/2018
Last updated
06/16/2018
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