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Individual

BRIAN TALLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
505 NE 87TH AVE STE LL10, VANCOUVER, WA 98664-1988
(360) 256-0026
Mailing address
505 NE 87TH AVE STE LL10, VANCOUVER, WA 98664-1988
(360) 256-0026

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OI00000478
WA
224P00000X
Prosthetist
Primary
PS60022981
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8528762
WA
Enumeration date
04/29/2008
Last updated
06/29/2009
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