Individual
DR. CRAIG EDWARD TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5100 S MACADAM AVE STE 200, PORTLAND, OR 97239-3827
(971) 202-5501
(971) 228-2983
Mailing address
815 NE DAVIS ST, PORTLAND, OR 97232-2964
(800) 896-6287
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD150779
OR
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
MD150779
OR
Other
Enumeration date
08/29/2006
Last updated
05/17/2024
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