Provider Demographics
NPI:1467492843
Name:TANGEMAN, ROGER RAYMOND (DC)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:RAYMOND
Last Name:TANGEMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W CATALDO AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-3202
Mailing Address - Country:US
Mailing Address - Phone:509-327-1994
Mailing Address - Fax:509-327-1911
Practice Address - Street 1:101 W CATALDO AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3202
Practice Address - Country:US
Practice Address - Phone:509-327-1994
Practice Address - Fax:509-327-1911
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00002328111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8857135Medicare PIN