Individual
HANNY AUGUSTINA TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 N GRAHAM ST, SUITE 200, PORTLAND, OR 97227-1683
(503) 413-4134
(503) 413-1895
Mailing address
300 N GRAHAM ST, SUITE 200, PORTLAND, OR 97227-1683
(503) 413-4134
(503) 413-1895
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00044047
WA
207R00000X
Internal Medicine Physician
Primary
MD28668
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
327890
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8414658
—
WA
01
—
P00347009
RAILROAD MEDICARE
WA
Enumeration date
10/27/2006
Last updated
03/25/2021
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