Individual
TARA GARDNER-BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1880 SW 6TH AVE STE 200, PORTLAND STATE UNIVERSITY, PORTLAND, OR 97201-5204
(503) 725-2800
Mailing address
1880 SW 6TH AVE STE 200, PORTLAND STATE UNIVERSITY, PORTLAND, OR 97201-5204
(503) 725-2800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201250044NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806098000
—
ID
Enumeration date
02/15/2006
Last updated
06/20/2016
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