Provider Demographics
NPI:1114016508
Name:STENSHOEL, TAMARA A (MD)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:A
Last Name:STENSHOEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 COBURG RD
Mailing Address - Street 2:STE 100
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7479
Mailing Address - Country:US
Mailing Address - Phone:541-342-8616
Mailing Address - Fax:541-686-4814
Practice Address - Street 1:10 COBURG RD
Practice Address - Street 2:STE 100
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7479
Practice Address - Country:US
Practice Address - Phone:541-342-8616
Practice Address - Fax:541-686-4814
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17674207V00000X, 207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR00WFBWDAMedicare PIN