Provider Demographics
NPI:1336353994
Name:SANDERS, TAMARA PATRICE (RN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:PATRICE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:
Other - Last Name:THRALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:14555 SW KILCHIS ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-5152
Mailing Address - Country:US
Mailing Address - Phone:503-750-0307
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine