Provider Demographics
NPI:1063123479
Name:HARTMAN, TIFFANIE ANNE (RPH)
Entity type:Individual
Prefix:DR
First Name:TIFFANIE
Middle Name:ANNE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 E PORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-5400
Mailing Address - Country:US
Mailing Address - Phone:503-537-1383
Mailing Address - Fax:503-537-1377
Practice Address - Street 1:3300 E PORTLAND RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-5400
Practice Address - Country:US
Practice Address - Phone:503-537-1383
Practice Address - Fax:503-537-1337
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR00191681835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist