MEDICARE: TAMARRA ROCHELLE RAGLAND

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
1	374J00000X	Doula	111118	OR

General Provider Information

NPI Number	:	1700635687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARRA ROCHELLE RAGLAND

Provider Business Mailing Address
First Line	:	10980 SW SUMMER LAKE DR
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-1974
Country	:	US
Telephone Number	:	310-405-2256
Fax Number	:

Provider Business Practice Location Address
First Line	:	10980 SW SUMMER LAKE DR
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-1974
Country	:	US
Telephone Number	:	310-405-2256
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2024
Last Update Date	:	05/14/2024

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Directions to “ TAMARRA ROCHELLE RAGLAND ” Practice Location

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