Doctor Name: | DR. TARA LAUREN WOFFORD |
NPI Number: | 1700028578 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | |
Business Practice Address: | 505 Ne 87th Ave Suite 46.7 Vancouver, WA - 986641989 |
Business Phone Number: | 3608285396 |
Business Fax Number: | 3608285455 |
Mailing Address: | 505 Ne 87th Ave, Suite 46.7 VANCOUVER |
State: | WA |
Postal Code: | 986641989 |
Phone Number: | 3608285396 |
Fax Number: | 3608285455 |
NPI Enumeration Date: | 03/25/2009 |
NPI Last Update Date: | 06/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |