Individual
TAWNY NICOLE WELSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9155 SW BARNES RD, SUITE 440, PORTLAND, OR 97225-6625
(503) 297-3766
(503) 297-8148
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA156597
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861774713
—
WA
05
—
500641513
—
OR
Enumeration date
09/16/2011
Last updated
01/06/2015
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