Individual
TIMOTHY ALLEN SPECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2144 HAWTHORNE ST, APT 56, FOREST GROVE, OR 97116-1749
(217) 416-9452
Mailing address
1406 NE 69TH AVE, PORTLAND, OR 97213-5302
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3631ATI
OR
Other
Enumeration date
10/10/2012
Last updated
10/08/2015
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