Individual
TIMOTHY KORM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
207 N FIR ST, FL 2, SISTERS, OR 97759
(978) 328-3023
(503) 388-7333
Mailing address
207 N FIR ST, FL 2, SISTERS, OR 97759
(978) 328-3023
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95191423
CA
163W00000X
Registered Nurse
RN2273544
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10050245
OR
Other
Enumeration date
02/24/2019
Last updated
04/24/2026
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