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Individual

TINA M. KAUFMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, CARDIOLOGY @UHN62, PORTLAND, OR 97239-3011
(503) 494-8750
(503) 494-8550
Mailing address
3181 SW SAM JACKSON PARK RD, CARDIOLOGY @UHN62, PORTLAND, OR 97239-3011
(503) 494-8750
(503) 494-8550

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01773
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
180162301
TX
01
8N4896
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/23/2006
Last updated
02/15/2011
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