Provider Demographics
NPI:1306808142
Name:BROWNING-TARBET, SUZANNE E (PA-C)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:E
Last Name:BROWNING-TARBET
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:E
Other - Last Name:MARCATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5579
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-5579
Mailing Address - Country:US
Mailing Address - Phone:541-548-7761
Mailing Address - Fax:541-526-6554
Practice Address - Street 1:1245 NW 4TH ST STE 101
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1680
Practice Address - Country:US
Practice Address - Phone:541-548-7761
Practice Address - Fax:541-526-6554
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA00983363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR223222Medicaid
OR0247744001OtherBLUE CROSS
ORQ19547Medicare UPIN
OR223222Medicaid