Individual
TANNY GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
(503) 972-9411
(503) 802-0460
Mailing address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201330145LPN
OR
Other
Enumeration date
05/01/2015
Last updated
05/01/2015
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