Individual
TARA E NYSOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1331 COLBY AVE, EVERETT, WA 98201
(425) 261-2000
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00045794
WA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD00045794
WA
208M00000X
Hospitalist Physician
MD00045794
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD45794
LICENSE
WA
Enumeration date
07/27/2006
Last updated
03/30/2021
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