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Individual

DR. TIMOTHY S ELZINGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(800) 813-2000
Mailing address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DR.0067315
CO
207Q00000X
Family Medicine Physician
Primary
MD156564
OR
207Q00000X
Family Medicine Physician
MD60137718
WA
207Q00000X
Family Medicine Physician
TE090719
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4301090719
ST LICENSE
MI
Enumeration date
06/29/2007
Last updated
05/04/2022
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