Healthcare Provider Details

I. General information

NPI: 1528024684
Provider Name (Legal Business Name): TIMOTHY PATRICK MCGEE MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 MOYER LN NW
SALEM OR
97304-3822
US

IV. Provider business mailing address

1493 AMMON ST NW
SALEM OR
97304-2035
US

V. Phone/Fax

Practice location:
  • Phone: 503-370-8990
  • Fax: 503-363-4214
Mailing address:
  • Phone: 503-375-3732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: