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NPI Code Detail

MEDICARE: MS. TESSA PEARL ADAIR

MEDICARE: MS. TESSA PEARL ADAIR
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
12255A2300XAthletic TrainerATAT10165564OR

General Provider Information

NPI Number : 1457710147
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TESSA PEARL ADAIR
Provider Business Mailing Address
First Line : 2200 NE NEFF RD STE 200
Second Line :
City : BEND
State : OR
Zip : 97701-4281
Country : US
Telephone Number : 541-410-6031
Fax Number :
Provider Business Practice Location Address
First Line : 2200 NE NEFF RD STE 200
Second Line :
City : BEND
State : OR
Zip : 97701-4281
Country : US
Telephone Number : 541-410-6031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2016
Last Update Date : 02/23/2016

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Directions to “ MS. TESSA PEARL ADAIR ” Practice Location

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