Haeryun Kim Tatum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L003600 Issued in OR

Practice address

913 NW Garden Valley Blvd
Roseburg, OR 97470-6523

Phone

(541) 440-1000

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497863138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 N RIVER DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974708008",
            "telephone_number": "541-229-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974706523",
            "telephone_number": "541-440-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "HAERYUN",
        "middle_name": "KIM",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L003600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rochelle Emma Taicz
• Kimberly Ann Talley, APRN
• Travis Tuan Tang
• Kay Tanner, CADC L
• Jason Tate
• Marshall Edward Tavares, MSN, RN
• Alexander Harrison Taylor, BS
• Harry A Taylor III, MD
• Kristi Taylor, CADC 1
• Patricia Ann Taylor

• All providers in Roseburg, OR
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.