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Individual

TIMOTHY LAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9800 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9750
(503) 652-2880
Mailing address
9800 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9750
(503) 652-2880

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
158967
OR

Other

Enumeration date
03/30/2009
Last updated
08/27/2012
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