Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD23962 | OR |
NPI | 1013925445 |
---|---|
Provider Name | Dr. Kevin J Tarrant |
First Address | Seattle, WA 98124-5147 |
Second Address | Portland, OR 97205-3536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 19/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
286633 | (05) | OR |
8318792 | (05) | WA |
F98345 | (02) | |
P00042701 | RR MEDICARE (01) | OR |