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NPI Code Detail

MEDICARE: MS. TANYA MARIE TOVER LMT

MEDICARE: MS. TANYA MARIE TOVER LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist9693OR

General Provider Information

NPI Number : 1053543827
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TANYA MARIE TOVER LMT
Provider Business Mailing Address
First Line : 1025 LAVONA DR NW
Second Line :
City : SALEM
State : OR
Zip : 97304-3743
Country : US
Telephone Number : 503-999-3577
Fax Number :
Provider Business Practice Location Address
First Line : 1880 LANCASTER DR NE STE 101
Second Line :
City : SALEM
State : OR
Zip : 97305-1040
Country : US
Telephone Number : 503-362-1002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2009
Last Update Date : 08/12/2009

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Directions to “ MS. TANYA MARIE TOVER LMT” Practice Location

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