Provider Demographics
NPI:1326440355
Name:STEINER, TISHA
Entity Type:Individual
Prefix:
First Name:TISHA
Middle Name:
Last Name:STEINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11035 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-2553
Mailing Address - Country:US
Mailing Address - Phone:503-258-4200
Mailing Address - Fax:503-230-8884
Practice Address - Street 1:2010 SE 182ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-5604
Practice Address - Country:US
Practice Address - Phone:503-972-9533
Practice Address - Fax:503-669-1055
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist