Individual
TANYA M LUBKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
12442 SW SCHOLLS FERRY RD, SUITE 100, TIGARD, OR 97223-3396
(503) 216-9900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO25113
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232436
—
OR
01
—
P00171596
RR MEDICARE
OR
Enumeration date
05/22/2006
Last updated
04/17/2012
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