Doctor Name: | TATYANA M WRIGHT |
NPI Number: | 1336236744 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | C0003088 |
Business Practice Address: | 870 S Front St Suite 200 Central Point, OR - 975022779 |
Business Phone Number: | 5416643346 |
Business Fax Number: | |
Mailing Address: | Po Box 3158, PORTLAND |
State: | OR |
Postal Code: | 972083158 |
Phone Number: | 5416643346 |
Fax Number: | |
NPI Enumeration Date: | 10/06/2006 |
NPI Last Update Date: | 06/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | C0003088 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |