Provider Demographics
NPI:1750700076
Name:HERTZ-TANG, AMBER L (MD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:HERTZ-TANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:L
Other - Last Name:HERTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9155 SW BARNES RD STE 402
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6631
Mailing Address - Country:US
Mailing Address - Phone:503-292-7704
Mailing Address - Fax:503-292-7046
Practice Address - Street 1:9155 SW BARNES RD STE 402
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6631
Practice Address - Country:US
Practice Address - Phone:503-292-7704
Practice Address - Fax:503-292-7046
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD201408207RN0300X, 207RN0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program