Individual
TIFFANY ANN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
2011 4TH ST, LA GRANDE, OR 97850-2511
(541) 963-4139
(541) 429-6612
Mailing address
2011 4TH ST, LA GRANDE, OR 97850-2511
(541) 963-4139
(541) 429-6612
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
112313
OR
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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