Individual
MRS. TARA BOATMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
0615 SW PALATINE HILL RD, PORTLAND, OR 97219-7879
(503) 768-7551
Mailing address
0615 SW PALATINE HILL RD, PORTLAND, OR 97219-7879
(503) 768-7551
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-10125947
OR
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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