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General NPI Number Information
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NPI Number | 1205272507
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Entity Type | Individual
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Provider Name | TIMOTHY LEONOR TAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 2815 EASTLAKE AVE E STE 240
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City | SEATTLE
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State | WA
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Zip | 98102-3086
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Country | US
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Telephone | 503-906-7300
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Fax | 503-245-8219
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Provider Business Mailing Address
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Address Line | PO BOX 230457
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City | PORTLAND
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State | OR
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Zip | 97281-0457
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Country | US
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Telephone | 503-906-7300
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Fax | 503-245-8219
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 125064426
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 70062322
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 02007763A
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License Number State | IN
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