Individual
TIFFANY TOMIYE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
34980 LAHAINA LOOP RD, CLOVERDALE, OR 97112-9112
(503) 310-3582
Mailing address
PO BOX 427, PACIFIC CITY, OR 97135-0427
(503) 310-3582
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10004660
OR
363LF0000X
Family Nurse Practitioner
5010214
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861990780
—
NC
Enumeration date
01/25/2018
Last updated
12/06/2023
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