Provider Demographics
NPI:1346357142
Name:CHAUDRY, TARANUM
Entity Type:Individual
Prefix:
First Name:TARANUM
Middle Name:
Last Name:CHAUDRY
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 1:965 LIBERTY ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4138
Mailing Address - Country:US
Mailing Address - Phone:503-588-2004
Mailing Address - Fax:503-588-2415
Practice Address - Street 1:965 LIBERTY ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4138
Practice Address - Country:US
Practice Address - Phone:503-588-2004
Practice Address - Fax:503-588-2415
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTO 363106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist