Individual
MARSHALL EDWARD TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97471-6523
(541) 440-1000
Mailing address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97471-6523
(541) 440-1000
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
749006
CA
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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