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1417176439 NPI number — GEORGE WILLIAM TINKER PHD

NPI Number: 1417176439
Health Care Provider/Practitioner: GEORGE WILLIAM TINKER PHD

Information about “1417176439” NPI (GEORGE WILLIAM TINKER PHD) exists in 1417176439 in HTML format HTML  |  1417176439 in plain Text format TXT  |  1417176439 in PDF (Portable Document Format) PDF  |  1417176439 in an XML format XML  formats.

NPI Number : 1417176439 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417176439",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TINKER",
    "FirstName": "GEORGE",
    "MiddleName": "WILLIAM",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6107 SW MURRAY BLVD",
    "SecondLineMailingAddress": "PMB 284",
    "MailingAddressCityName": "BEAVERTON",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97008-4467",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "503-780-7244",
    "MailingAddressFaxNumber": "503-644-9506",
    "FirstLinePracticeLocationAddress": "3033 NE BROADWAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORTLAND",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97232-1810",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "503-780-7244",
    "PracticeLocationAddressFaxNumber": "503-644-9506",
    "EnumerationDate": "04/25/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103TC0700X",
        "TaxonomyName": "Clinical Psychologist",
        "LicenseNumber": "869",
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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