Provider Demographics
NPI:1205396397
Name:WALKER, TAMAR VIRTELLE LAN (MD, MBA)
Entity type:Individual
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First Name:TAMAR
Middle Name:VIRTELLE LAN
Last Name:WALKER
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Gender:
Credentials:MD, MBA
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Mailing Address - Street 1:5301 SOUTH CONGRESS AVENUE
Mailing Address - Street 2:3 SOUTH
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462
Mailing Address - Country:US
Mailing Address - Phone:561-548-1711
Mailing Address - Fax:561-548-1743
Practice Address - Street 1:3303 S BOND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4501
Practice Address - Country:US
Practice Address - Phone:503-494-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-23
Last Update Date:2025-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD219471208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery