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Contact Information

TARVEZ TUCKER, MD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR97239-3098
 Phone: 503-418-4980
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurocritical Care

2084A2900X 86 Physician/Neuropsychiatry
 

Neurology

2084N0400X 13 Physician/Neurology
Indicates primary specialty

NPI Profile & details for TARVEZ TUCKER · (Female)

NPI # 1770537839
Status Active
Credentials MD
Entity Individual
Enumeration date 05/20/2006
Last updated 01/14/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • OR License # MD 158051
  • OR License # MD158051
  • KY Medicaid 64096597
  • OR Medicaid 500648851
Hospital affiliation(s)
  • OHSU HOSPITAL AND CLINICS - (Acute Care)
    3181 SW SAM JACKSON PARK ROAD
    PORTLAND, OR 97239
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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