Healthcare Provider Details

I. General information

NPI: 1598183303
Provider Name (Legal Business Name): TARIN CHASE WORREST MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARIN CHASE RICHARDS

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 FORT MISSOULA RD STE 102
MISSOULA MT
59804-7401
US

IV. Provider business mailing address

2831 FORT MISSOULA RD STE 102
MISSOULA MT
59804-7401
US

V. Phone/Fax

Practice location:
  • Phone: 406-728-0285
  • Fax:
Mailing address:
  • Phone: 406-728-0285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMED-PHYS-LIC-100134
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: