Individual
CALLAHAN TIMOTHY ROSE NODSLE-VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13765 VINTAGE DR SW, PORT ORCHARD, WA 98367-7391
(253) 970-2414
Mailing address
12223 MOUNTAIN CRUISER LN NW APT B108, SILVERDALE, WA 98383-8019
(206) 866-8246
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/13/2025
Last updated
10/24/2025
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