Individual
ROBERT E TENNANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11782 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
16898
OR
207X00000X
Orthopaedic Surgery Physician
Primary
MD16898
OR
208VP0014X
Interventional Pain Medicine Physician
MD16898
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020383
—
OR
Enumeration date
07/17/2006
Last updated
05/23/2022
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