| Tim Foulke Ms, Pmhnp Pc | |
|
2720 Ne 33rd Ave Portland OR 97212-3648 | |
| (503) 422-3253 | |
| Not Available |
| Full Name | Tim Foulke Ms, Pmhnp Pc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2720 Ne 33rd Ave, Portland, Oregon |
| Authorized Official Name and Position | Tim Charles Foulke (PRESIDENT) |
| Authorized Official Contact | 5034223253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tim Foulke Ms, Pmhnp Pc 2720 Ne 33rd Ave Portland OR 97212-3648 Ph: (503) 422-3253 | Tim Foulke Ms, Pmhnp Pc 2720 Ne 33rd Ave Portland OR 97212-3648 Ph: (503) 422-3253 |
| NPI Number | 1497906721 |
|---|---|
| Provider Enumeration Date | 10/06/2008 |
| Last Update Date | 10/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497906721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 08004508N6 (Oregon) | Primary |
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