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1164551172
JONATHAN MICHAEL TATE
PORTLAND, OR
NPI
1164551172
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: OR 161824)
Enumeration Date
2007-03-05
Last Update Date
2014-09-23
Business Address
-- JONATHAN MICHAEL TATE MD
2801 N GANTENBEIN AVE
PORTLAND, OR 97227-1623
Phone number: 503-413-8407
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Mailing Address
-- JONATHAN MICHAEL TATE MD
PO BOX 3777
PORTLAND, OR 97208-3777
Phone number: 503-413-8407
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