Individual
DR. TIMOTHY JOHN EDVALSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3900 DOUGLAS WAY, LAKE OSWEGO, OR 97035-3446
(503) 636-8446
(503) 636-4446
Mailing address
3900 DOUGLAS WAY, LAKE OSWEGO, OR 97035-3446
(503) 636-8446
(503) 636-4446
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5825
OR
Other
Enumeration date
09/16/2005
Last updated
07/08/2007
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