Individual
DR. TANA MARIE HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19260 SW 65TH AVE STE 270, SUITE B2, TUALATIN, OR 97062-5705
(503) 699-0764
(503) 329-1851
Mailing address
PO BOX 869, TUALATIN, OR 97062-0869
(503) 691-0169
(503) 699-9237
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD24660
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029123
—
OR
Enumeration date
11/02/2005
Last updated
06/25/2013
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