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Individual

DR. TIMOTHY GRANT MADISON II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1260 SW 66TH AVE APT 5100, PORTLAND, OR 97225-6077
(503) 869-3664
Mailing address
1260 SW 66TH AVE APT 5100, PORTLAND, OR 97225-6077
(503) 869-3664

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60900
OR

Other

Enumeration date
08/04/2016
Last updated
08/04/2016
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