Individual
JEANETTE L. TANEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
10100 SE SUNNYSIDE RD, MT. TALBERT MEDICAL OFFICE, CLACKAMAS, OR 97015-8970
(503) 571-6166
Mailing address
10100 SE SUNNYSIDE RD, MT. TALBERT MEDICAL OFFICE, CLACKAMAS, OR 97015-8970
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
160615
OR
Other
Enumeration date
02/28/2006
Last updated
03/04/2013
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