Individual
JODY H TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2222 NW LOVEJOY ST, SUITE 411, PORTLAND, OR 97210-3033
(503) 413-5702
(503) 413-6499
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
MD161713
OR
207RP1001X
Pulmonary Disease Physician
MD60337788
WA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
MD161713
OR
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD60337788
WA
Other
Enumeration date
03/01/2007
Last updated
10/07/2015
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