Individual
TIMOTHY CARLTON ATHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3640 NW SAMARITAN DR STE 100A, CORVALLIS, OR 97330-3784
(541) 768-5205
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
F1350
TX
207RC0000X
Cardiovascular Disease Physician
Primary
MD27273
OR
Other
Enumeration date
07/21/2006
Last updated
11/04/2020
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