Individual
RICHARD DEAN TANKSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
2978 WAVERLY WAY, MEDFORD, OR 97504-5075
(505) 435-0519
Mailing address
2978 WAVERLY WAY, MEDFORD, OR 97504-5075
(505) 435-0519
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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