Healthcare Provider Details

I. General information

NPI: 1972683886
Provider Name (Legal Business Name): TAMI OZGUL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMI TERRAY KAUFFMAN

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6926 NE FOURTH PLAIN BLVD
VANCOUVER WA
98661-7254
US

IV. Provider business mailing address

6926 NE FOURTH PLAIN BLVD
VANCOUVER WA
98661-7254
US

V. Phone/Fax

Practice location:
  • Phone: 360-993-3000
  • Fax:
Mailing address:
  • Phone: 360-993-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number240
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: