Tanasbourne Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD15139 Issued in OR

Legal business name

TANASBOURNE FAMILY MEDICINE LLC

Practice address

17200 NW Corridor CT
Ste 105
Beaverton, OR 97006-3295

Phone

(503) 614-8400

Fax

(503) 614-8411

NPI assigned

Dec 19, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Craig Gilpin Myers, M.D.

Title

Owner

Phone

(503) 614-8400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan C Chitwood, MD

  • Family Medicine Physician
  • Beaverton, OR
  • NPI 1619197480
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1144383993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT",
            "address_2": "STE 105",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-614-8400",
            "fax_number": "503-614-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT",
            "address_2": "STE 105",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-614-8400",
            "fax_number": "503-614-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANASBOURNE FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "GILPIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-614-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD15139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154344",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tannaz Talepasand
• May Tam, COTA
• Emily Tan
• Min-U Tan
• Liana Kahealani Phillips Tanaka, PHARMD
• Tanasbourne Pediatrics, LLC
• Charles Taneous, RN
• Anthony Tangalin, L.M.T
• Kylie Taniguchi
• Kirsten Tankersley

• Family Medicine Physician in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.