Individual
TARA G MCCANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT
Contact information
Practice address
7927 SE ORIENT DR, GRESHAM, OR 97080
(503) 663-0332
(503) 663-1114
Mailing address
6430 SE JENNINGS AVE, MILWAUKIE, OR 97267-6317
(360) 907-5874
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1032940
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227783
—
OR
Enumeration date
01/24/2006
Last updated
07/09/2007
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