Provider Demographics
NPI:1801766837
Name:HOWARD, TATYANA (LPN)
Entity type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2654 WINDSTREAM ST
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-3030
Mailing Address - Country:US
Mailing Address - Phone:971-506-7049
Mailing Address - Fax:
Practice Address - Street 1:917 SW OAK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2829
Practice Address - Country:US
Practice Address - Phone:971-808-6597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201401428164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty