Individual
TIMMOTHY PAUL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(971) 747-6121
Mailing address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(971) 747-6121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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