Individual
TIMOTHY C THUNDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 SW 13TH AVE, PORTLAND, OR 97205-1902
(503) 221-0161
Mailing address
800 SW 13TH AVE, PORTLAND, OR 97205-1902
(503) 221-0161
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD22487
OR
208M00000X
Hospitalist Physician
MD22487
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110219893
RR MEDICARE - PHS
OR
05
—
288357
—
OR
Enumeration date
07/09/2006
Last updated
11/25/2020
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