Organization
TIM FOULKE MS, PMHNP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM CHARLES FOULKE NP (PRESIDENT)
(503) 422-3253
Entity
Organization
Contact information
Practice address
2720 NE 33RD AVE, PORTLAND, OR 97212-3648
(503) 422-3253
Mailing address
2720 NE 33RD AVE, PORTLAND, OR 97212-3648
(503) 422-3253
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
08004508N6
OR
Other
Enumeration date
10/06/2008
Last updated
10/06/2008
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