Individual
TIMOTHY GAFFNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 W BROADWAY ST STE 320, MISSOULA, MT 59802-4003
(406) 329-5615
(406) 329-5606
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 329-5615
(406) 329-5606
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-102492
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/24/2020
Last updated
10/28/2021
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