Healthcare Provider Details
I. General information
NPI: 1821255399
Provider Name (Legal Business Name): TIMBERVIEW INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5901 N LIDGERWOOD ST SUITE 219
SPOKANE WA
99208-5095
US
IV. Provider business mailing address
PO BOX 28840
SPOKANE WA
99228-8840
US
V. Phone/Fax
- Phone: 509-456-5733
- Fax: 509-327-5191
- Phone: 509-456-5733
- Fax: 509-327-5191
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TERI
A
TUPPER
Title or Position: OWNER
Credential: ARNP
Phone: 509-456-5733