Goetz-Kennedy, Tawnie

Goetz-Kennedy, Tawnie is an sole proprietor health care provider with primary practice located at 2700 Stewart Parkway Annex B, Roseburg OR 97471. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Goetz-Kennedy, Tawnie can be contacted via phone (541) 440-3532.

Contact Information

Primary practice address
2700 Stewart Parkway Annex B Roseburg OR 97471
Phone: (541) 440-3532
Fax: (541) 440-3554
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1023353786
LBN Legal business name Goetz-Kennedy, Tawnie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 6th, 2012
Last updated May 7th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023353786 NPPES
Oregon MEDICAID 500663505

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