Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD184038 | OR |
N | 208200000X | Surgeon | MD184038 | OR |
N | 208600000X | Surgeon | MD184038 | OR |
NPI | 1679027874 |
---|---|
Provider Name | Dr. Ephraim Shin-Tian Tang |
First Address | Portland, OR 97213-2933 |
Second Address | Portland, OR 97213-2933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2016 |
Last Update Date | 17/11/2017 |