Individual
TIMMOTHY D RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
606 MEDICAL PKWY, ENTERPRISE, OR 97828
(541) 426-4524
Mailing address
600 W GREENWOOD ST SPC 8, ENTERPRISE, OR 97828-1430
(541) 398-2227
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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