Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 13092 | WA |
N | 207W00000X | Ophthalmologist | 25MA02104100 | NJ |
N | 207W00000X | Ophthalmologist | 7514 | AZ |
N | 207W00000X | Ophthalmologist | G8840 | CA |
N | 207W00000X | Ophthalmologist | MD08581 | OR |
N | 207W00000X | Ophthalmologist | R4176 | MO |
NPI | 1013959279 |
---|---|
Provider Name | Emanuel Tanne |
First Address | Vancouver, WA 98661 |
Second Address | Vancouver, WA 98661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1861509 | (05) | WA |
A08088 | (02) |