Individual
TANNER WINN ANDRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
888 SWIFT BLVD, RICHLAND, WA 99352-3514
(949) 212-6116
Mailing address
19361 JASPER HILL RD, TRABUCO CANYON, CA 92679-1185
(949) 212-6116
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1151313
TN
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/23/2018
Last updated
03/29/2023
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