Individual
DR. TARA SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, MBA
Contact information
Practice address
11845 SW GREENBURG RD STE 210, TIGARD, OR 97223-6464
(971) 264-0879
(971) 266-4521
Mailing address
901 BRUTSCHER ST # D141, NEWBERG, OR 97132-6096
(971) 264-0879
(971) 925-8613
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2324
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500706752
DMAP
OR
Enumeration date
02/26/2008
Last updated
03/03/2020
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