MEDICARE: DR. TASHA RENEE POWELL M.D.

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	2084N0400X	Neurology Physician	108862	AK
2	2084N0400X	Neurology Physician	0101249104	VA
3	2084N0400X	Neurology Physician	MD60552938	WA
4	2084N0400X	Neurology Physician	60190	AZ

General Provider Information

NPI Number	:	1790914091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TASHA RENEE POWELL M.D.

Provider Business Mailing Address
First Line	:	14362 N FRANK LLOYD WRIGHT BLVD STE 1340
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-8878
Country	:	US
Telephone Number	:	480-770-0427
Fax Number	:	480-770-0428

Provider Business Practice Location Address
First Line	:	14362 N FRANK LLOYD WRIGHT BLVD STE 1340
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-8878
Country	:	US
Telephone Number	:	480-770-0427
Fax Number	:	480-770-0428

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

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	09/22/2025

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