MEDICARE: DR. TIMOTHY W YOUNG DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO00000389	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508855966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY W YOUNG DPM

Provider Business Mailing Address
First Line	:	2039 E BEAVER LAKE DR SE
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98075-7920
Country	:	US
Telephone Number	:	425-391-0208
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 NW GILMAN BLVD
Second Line	:	SUITE 303
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-2483
Country	:	US
Telephone Number	:	425-391-8666
Fax Number	:	425-392-6433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	12/18/2014

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Directions to “ DR. TIMOTHY W YOUNG DPM” Practice Location

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