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NPI Code Detail

MEDICARE: TAMMY JO RONDEAU

MEDICARE: TAMMY JO RONDEAU
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
1172V00000XCommunity Health Worker110706OR

General Provider Information

NPI Number : 1598608119
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY JO RONDEAU
Provider Business Mailing Address
First Line : 38 N RIVER DR
Second Line :
City : ROSEBURG
State : OR
Zip : 97470-9473
Country : US
Telephone Number : 541-677-3382
Fax Number :
Provider Business Practice Location Address
First Line : 2700 NW STEWART PKWY
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1281
Country : US
Telephone Number : 541-677-3382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ TAMMY JO RONDEAU ” Practice Location

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