Healthcare Provider Details

I. General information

NPI: 1437799871
Provider Name (Legal Business Name): FELIX ACHILLE GOUANETTE TANKEU DNP, FNP- BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 COUNTRY CLUB RD STE 100
EUGENE OR
97401-2240
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 541-463-2390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR218678
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: