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1922110972 NPI number — AUDREY ELLEN TARR MD

NPI Number: 1922110972
Health Care Provider/Practitioner: AUDREY ELLEN TARR MD

Information about “1922110972” NPI (AUDREY ELLEN TARR MD) exists in 1922110972 in HTML format HTML  |  1922110972 in plain Text format TXT  |  1922110972 in PDF (Portable Document Format) PDF  |  1922110972 in an XML format XML  formats.

NPI Number : 1922110972 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1922110972",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TARR",
    "FirstName": "AUDREY",
    "MiddleName": "ELLEN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WRIGHT",
    "OtherFirstName": "AUDREY",
    "OtherMiddleName": "ELLEN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1040 NW 22ND AVE, SUITE 600",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PORTLAND",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97210-3041",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "503-413-5787",
    "MailingAddressFaxNumber": "503-413-5788",
    "FirstLinePracticeLocationAddress": "1040 NW 22ND AVE, SUITE 600",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORTLAND",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97210-3041",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "503-413-5787",
    "PracticeLocationAddressFaxNumber": "503-413-5788",
    "EnumerationDate": "08/31/2006",
    "LastUpdateDate": "07/15/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207VF0040X",
          "TaxonomyName": "Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician",
          "LicenseNumber": "MD00040629",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207VX0000X",
          "TaxonomyName": "Obstetrics Physician",
          "LicenseNumber": "MD23494",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207VF0040X",
          "TaxonomyName": "Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician",
          "LicenseNumber": "MD23494",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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