Individual
TIMOTHY JOHN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6120 N MAYFAIR ST, SUITE 101, SPOKANE, WA 99208-1033
(509) 489-7483
(509) 489-4572
Mailing address
6120 N MAYFAIR ST, SUITE 101, SPOKANE, WA 99208-1033
(509) 489-9483
(509) 489-4572
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00019722
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10002943
BS OF IDAHO
—
05
—
8457202
—
WA
01
—
GA5801
AZURIS
—
Enumeration date
10/14/2005
Last updated
01/25/2010
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