Individual
TIMOTHY C. MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
2034 SE DIVISION, PORTLAND, OR 97214
(503) 238-6801
(503) 238-6810
Mailing address
6212 SE 91ST AVE, PORTLAND, OR 97266-5212
(503) 703-8683
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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