Individual
TIM SPARROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3840 NE COUCH ST, PORTLAND, OR 97232-3426
(218) 230-6164
Mailing address
3840 NE COUCH ST, PORTLAND, OR 97232-3426
(218) 230-6164
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/16/2007
Last updated
11/05/2007
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