Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | DEM-LD-10136418 | OR |
NPI | 1144541269 |
---|---|
Provider Name | Tarrin Fletcher |
First Address | Tigard, OR 97224-4886 |
Second Address | Tigard, OR 97224-4886 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 14/06/2010 |