Individual
TAMERA S FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD STE 100, TIGARD, OR 97224-7259
(503) 216-0700
Mailing address
18040 SW LOWER BOONES FERRY RD STE 100, TIGARD, OR 97224-7259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA195237
OR
363AM0700X
Medical Physician Assistant
6069635270
WA
363AM0700X
Medical Physician Assistant
PA195237
OR
Other
Enumeration date
03/02/2015
Last updated
11/04/2025
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