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Individual

TIMOTHY M DENMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4035 MERCANTILE DR, SUITE 216, LAKE OSWEGO, OR 97035-2546
(503) 636-2551
(503) 636-3055
Mailing address
6420 SW MACADAM AVE, SUITE 216, PORTLAND, OR 97239-3507
(503) 244-8601
(503) 244-3013

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD09153
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04877-7
OR
01
180022040
RAILROAD MEDICARE
OR
Enumeration date
03/17/2006
Last updated
05/29/2013
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