Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD00040629 | WA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD23494 | OR |
N | 207VX0000X | Obstetrician | MD23494 | OR |
NPI | 1922110972 |
---|---|
Provider Name | Dr. Audrey Ellen Tarr |
First Address | Portland, OR 97210-3041 |
Second Address | Portland, OR 97210-3041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 15/07/2019 |