Travis Tuan Tang

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RPH-0017619 Issued in OR

Practice address

2125 NW Stewart Pkwy
Roseburg, OR 97471-1693

Phone

(541) 957-8544

NPI assigned

Jan 14, 2020

Last updated

Jan 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1962042242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 NE LINCOLN ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702121",
            "telephone_number": "541-580-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711693",
            "telephone_number": "541-957-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "TRAVIS",
        "middle_name": "TUAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RPH-0017619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conner Tabor
• Kimberly Tabor
• Megan Taddei
• Rochelle Emma Taicz
• Kimberly Ann Talley, APRN
• Kay Tanner, CADC L
• Jason Tate
• Haeryun Kim Tatum, LCSW
• Marshall Edward Tavares, MSN, RN
• Alexander Harrison Taylor, BS

• Community/Retail Pharmacy in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.