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General NPI Number Information
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NPI Number | 1114056306
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Entity Type | Organization
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Legal Business Name | TABOR INDUSTRIES, INC
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 10/07/2009
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Provider Practice Location Address
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Address Line | 2236 SE WASHINGTON ST SUITE D
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City | MILWAUKIE
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State | OR
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Zip | 97222-7696
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Country | US
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Telephone | 503-659-3305
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Fax |
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Provider Business Mailing Address
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Address Line | 27 S STATE ST SUITE 240
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-3935
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Country | US
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Telephone | 503-636-9608
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Fax | 503-636-9600
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANET M TABOR
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Credential |
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Telephone | 503-636-9608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 15143
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License Number State | OR
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