Timothy Moore | |
384 Sw Upper Terrace Dr Ste 212 Bend OR 97702-3514 | |
(541) 306-0474 | |
Not Available |
Full Name | Timothy Moore |
---|---|
Speciality | Counselor |
Location | 384 Sw Upper Terrace Dr Ste 212, Bend, Oregon |
Authorized Official Name and Position | Timothy Moore (OWNER) |
Authorized Official Contact | 5413060474 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Timothy Moore 250 Nw St Helens Pl Bend OR 97703-2661 Ph: () - | Timothy Moore 384 Sw Upper Terrace Dr Ste 212 Bend OR 97702-3514 Ph: (541) 306-0474 |
NPI Number | 1821667304 |
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Provider Enumeration Date | 06/21/2021 |
Last Update Date | 06/21/2021 |
Certification Date | 06/21/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821667304 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
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