Provider Demographics
NPI:1093010217
Name:HONEA, TANI ROSE (RDMS (OB))
Entity type:Individual
Prefix:
First Name:TANI
Middle Name:ROSE
Last Name:HONEA
Suffix:
Gender:F
Credentials:RDMS (OB)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 W VINE ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-3345
Mailing Address - Country:US
Mailing Address - Phone:541-258-3500
Mailing Address - Fax:541-258-3350
Practice Address - Street 1:136 W VINE ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-3345
Practice Address - Country:US
Practice Address - Phone:541-258-3500
Practice Address - Fax:541-258-3350
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1369542471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
136954OtherAMERICAN REGISTRY FOR DIAGNOSTIC MEDICAL SONOGRAPHY
OR912828OtherOREGON BOARD OF MEDICAL IMAGING