Individual
DR. TIMOTHY P JANZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10803 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249
Mailing address
10803 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD16918
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003350006
BC/BS
OR
05
—
011549
—
OR
01
—
430120810002
PACIFICARE
OR
Enumeration date
06/30/2006
Last updated
07/08/2007
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