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NPI Code Detail

MEDICARE: MRS. TAWNIE DEAN COWAN D.P.T.

MEDICARE: MRS. TAWNIE DEAN COWAN D.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist6671OR

General Provider Information

NPI Number : 1033491188
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TAWNIE DEAN COWAN D.P.T.
Provider Business Mailing Address
First Line : 1310 2ND ST
Second Line :
City : COLUMBIA CITY
State : OR
Zip : 97018-9770
Country : US
Telephone Number : 386-871-5310
Fax Number :
Provider Business Practice Location Address
First Line : 936 SE OAK ST
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-4214
Country : US
Telephone Number : 503-546-6392
Fax Number : 503-546-9150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2011
Last Update Date : 09/14/2011

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