Individual
TIMOTHY ISAMU O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
Mailing address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD60658842
WA
208000000X
Pediatrics Physician
ML60368579
WA
Other
Enumeration date
03/28/2013
Last updated
06/02/2016
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