Provider Demographics
NPI:1912244690
Name:HUGHES, TARALEE AMBER (LMT)
Entity Type:Individual
Prefix:
First Name:TARALEE
Middle Name:AMBER
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 MANZANITA ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-2052
Mailing Address - Country:US
Mailing Address - Phone:541-890-4468
Mailing Address - Fax:
Practice Address - Street 1:323 MANZANITA ST
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2052
Practice Address - Country:US
Practice Address - Phone:541-890-4468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19294174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist