| Doctor Name: | MS. TAMMY MARIE LUNDBOM |
| NPI Number: | 1194862839 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 2714 Ne 205th Ave Apt 228 Fairview, OR - 970249649 |
| Business Phone Number: | 5039149768 |
| Business Fax Number: | |
| Mailing Address: | 2714 Ne 205th Ave Apt 228, FAIRVEW |
| State: | OR |
| Postal Code: | 97024 |
| Phone Number: | 5039149768 |
| Fax Number: | |
| NPI Enumeration Date: | 01/31/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |