| Doctor Name: | TAMARA LYNN HOUSTON |
| NPI Number: | 1497172761 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA166331 |
| Business Practice Address: | 8385 Division Rd White City, OR - 975031176 |
| Business Phone Number: | 5418265853 |
| Business Fax Number: | 5418265843 |
| Mailing Address: | 19 Myrtle St, MEDFORD |
| State: | OR |
| Postal Code: | 975047337 |
| Phone Number: | 5418265853 |
| Fax Number: | 5418265843 |
| NPI Enumeration Date: | 03/25/2014 |
| NPI Last Update Date: | 03/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA166331 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |