Healthcare Provider Details

I. General information

NPI: 1912840943
Provider Name (Legal Business Name): TAREN RAMBECK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 MANZANITA ST NE
KEIZER OR
97303-1925
US

IV. Provider business mailing address

2024 MANZANITA ST NE
KEIZER OR
97303-1925
US

V. Phone/Fax

Practice location:
  • Phone: 503-930-2494
  • Fax:
Mailing address:
  • Phone: 503-930-2494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: