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General NPI Number Information
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NPI Number | 1841686615
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Entity Type | Individual
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Provider Name | TIMOTHY DARLAND EMR
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Gender | Male
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 701 STRUCK RD
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City | LYLE
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State | WA
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Zip | 98635-9428
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Country | US
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Telephone | 509-209-4381
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BARTLETT WAY
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City | LYLE
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State | WA
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Zip | 98635-9451
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Country | US
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Telephone | 509-209-4381
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Fax |
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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 | 146D00000X
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Taxonomy Name | Personal Emergency Response Attendant
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License Number | 60081201
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License Number State | WA
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