Individual
CORVIN W TOMPKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
11782 SW BARNES RD, SUITE 200, PORTLAND, OR 97225-5914
(503) 906-4300
(503) 906-4333
Mailing address
11782 SW BARNES RD, SUITE 200, PORTLAND, OR 97225-5914
(503) 906-4300
(503) 906-4333
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
01-120
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-120
CERTIFICATION NUMBER
OR
Enumeration date
02/07/2017
Last updated
02/07/2017
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