Healthcare Provider Details

I. General information

NPI: 1922370469
Provider Name (Legal Business Name): BRIAN R TIMMS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 03/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 NE 134TH ST STE 100
VANCOUVER WA
98685
US

IV. Provider business mailing address

5707 NE 62ND CIR
VANCOUVER WA
98661-1582
US

V. Phone/Fax

Practice location:
  • Phone: 360-574-6594
  • Fax: 360-574-2235
Mailing address:
  • Phone: 360-560-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60822653
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60143913
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: