Provider Demographics
NPI:1851466445
Name:SCHWAB, TARA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:ANN
Last Name:SCHWAB
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 1:8332 SE 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-7102
Mailing Address - Country:US
Mailing Address - Phone:503-595-9300
Mailing Address - Fax:503-595-9301
Practice Address - Street 1:8332 SE 13TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-7102
Practice Address - Country:US
Practice Address - Phone:503-595-9300
Practice Address - Fax:503-595-9301
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27838208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics