Provider Demographics
NPI:1356162929
Name:TUN, AYE HSAY TAR
Entity type:Individual
Prefix:
First Name:AYE HSAY TAR
Middle Name:
Last Name:TUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 NW 13TH AVE APT 516
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3697
Mailing Address - Country:US
Mailing Address - Phone:607-227-6674
Mailing Address - Fax:
Practice Address - Street 1:1650 NW 13TH AVE APT 516
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3697
Practice Address - Country:US
Practice Address - Phone:607-227-6674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician