Healthcare Provider Details

I. General information

NPI: 1427947225
Provider Name (Legal Business Name): TATUM ZAPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2025
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16083 SW UPPER BOONES FERRY RD STE 130
TIGARD OR
97224-7737
US

IV. Provider business mailing address

11740 SW 72ND AVE APT 211
TIGARD OR
97223-7723
US

V. Phone/Fax

Practice location:
  • Phone: 503-603-9087
  • Fax: 503-603-9122
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA232122
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: