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Individual

BRIAN ANDREW TIMM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
2222 NW LOVEJOY ST, SUITE 315, PORTLAND, OR 97210-3033
(503) 226-6321
(503) 227-3422
Mailing address
975 SE SANDY BLVD, SUITE 201, PORTLAND, OR 97214-1308
(503) 236-0775
(503) 236-0786

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA150327
OR
363AS0400X
Surgical Physician Assistant
PA60121081
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8557449
WA
Enumeration date
10/13/2009
Last updated
07/27/2010
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