Provider Demographics
NPI:1821380767
Name:RUBINSTEIN, TANYA (MD)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:
Last Name:RUBINSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 ELM ST SW STE 200
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1957
Mailing Address - Country:US
Mailing Address - Phone:541-812-4850
Mailing Address - Fax:541-812-4889
Practice Address - Street 1:705 ELM ST SW STE 200
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1957
Practice Address - Country:US
Practice Address - Phone:541-812-4850
Practice Address - Fax:541-812-4889
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ORMD177051207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program