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General NPI Number Information
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NPI Number | 1477142081
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Entity Type | Individual
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Provider Name | TANNER OLIVER
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Gender | Male
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Dates
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Enumeration Date | 01/18/2021
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 6075 S QUEBEC ST STE 200
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City | CENTENNIAL
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State | CO
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Zip | 80111-4535
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Country | US
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Telephone | 720-390-6932
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 DTC PKWY STE 450
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-3027
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Country | US
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Telephone | 720-390-6932
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09929693
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License Number State | CO
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