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TABITHA WALLER FNP
NPI 1619410982
Nurse Practitioner - Family in Roseburg, OR

Active since November 18, 2016
1813 W HARVARD AVE, SUITE 241, ROSEBURG, OR 97471(541) 440-6390 Get Directions Write a Review

NPPES record last updated: November 18, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tabitha Waller Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TABITHA WALLER FNP (NPI 1619410982) is an individual family provider in Roseburg, Oregon, licensed in Oregon (20160204NP-PP) and active in the NPI registry since November 2016.

NPPES Registry Identity

NPI1619410982
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTABITHA WALLERCredential: FNP
Location Address1813 W HARVARD AVE, SUITE 241Roseburg, OR 97471-2752
Mailing Address1813 W Harvard Ave, Suite 241Roseburg, OR 97471-2752
Phone(541) 440-6390
Sole ProprietorNo
Enumeration DateNovember 18, 2016
✔ NPI 1619410982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OR · 20160204NP-PP
1813 W HARVARD AVE, Roseburg, OR 97471
Open in Google Maps ↗

Other Identifiers 1

Other20160204NP-PPOR · State License

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KURT A BRICKNER DO
Internal Medicine
1813 W HARVARD AVE, SUITE 241
ROSEBURG, OR 97471
Douglas County (541) 673-5579
LAURENCE M SHARP DO PC
Family Medicine
1813 W HARVARD AVE, SUITE 426
ROSEBURG, OR 97471
Douglas County (541) 459-1611
PAUL DOUGLAS REICHERTER MD
Dermatology (MOHS-Micrographic Surgery)
1813 W HARVARD AVE, STE 310
ROSEBURG, OR 97471
Douglas County (541) 672-7546
MS. VIRGINIA RUTH TERRY R.D.
Dietitian, Registered
1813 W HARVARD AVE, STE 427
ROSEBURG, OR 97471
Douglas County (541) 784-5966
COMMUNITY HEALTH ALLIANCE
Community/Behavioral Health
1813 W HARVARD AVE, STE 448
ROSEBURG, OR 97471
Douglas County (541) 464-4079
UMPQUA MEDICAL GROUP, LLC
Internal Medicine
1813 W HARVARD AVE, SUITE 206
ROSEBURG, OR 97471
Douglas County (541) 672-1685
DOUGLAS MEDICAL GROUP, LLC
Family Medicine
1813 W HARVARD AVE, SUITES 110, 201, 422, 426
ROSEBURG, OR 97471
Douglas County (541) 957-3079
WILLIAM B TOWNSEND MD
Internal Medicine
1813 W HARVARD AVE, SUITE 423
ROSEBURG, OR 97471
Douglas County (541) 440-6323

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tabitha Waller's NPI number?

The NPI number for Tabitha Waller is 1619410982. It was assigned to this individual provider in the NPPES registry on November 18, 2016.

Where is Tabitha Waller located?

Tabitha Waller practices at 1813 W Harvard Ave Suite 241, Roseburg, OR 97471. The listed phone number is (541) 440-6390.

What is Tabitha Waller's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Tabitha Waller was last updated on November 18, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.