TIARA F PACKER PA-C NPI 1447313010

NPI Information

NPI: 1447313010
Provider Name: TIARA F PACKER, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
3620 NW SAMARITAN DRIVE
SUITE 202
CORVALLIS, OR
ZIP 97330
Phone: (541) 768-4810
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Tiara F Packer, PA-C is a surgical physician assistant in Corvallis, OR. Tiara F Packer, PA-C NPI is 1447313010. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3620 NW SAMARITAN DRIVE
SUITE 202
CORVALLIS, OR
ZIP 97330
Phone: (541) 768-4810

The enumeration date for this NPI number is 12/18/2006 and was last updated on 9/24/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	0614	NEW HAMPSHIRE	No
2	363AS0400X	Physician Assistant	Surgical	PA130018	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01Y005045NH02	OTHER	NEW HAMPSHIRE	ANTHEM BCBS MCH
2	30334821	MEDICAID	NEW HAMPSHIRE
3	AP2779	MEDICARE PIN	NEW HAMPSHIRE
4	01Y005045NH03	OTHER	NEW HAMPSHIRE	ANTHEM BCBS MOA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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