Individual
TANYA L. PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 535-3890
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD25729
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213433
—
OR
Enumeration date
08/01/2006
Last updated
07/16/2007
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