1821255399 NPI number — TIMBERVIEW INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821255399 NPI number — TIMBERVIEW INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TIMBERVIEW INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821255399
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 28840
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99228-8840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-456-5733
Provider Business Mailing Address Fax Number:
509-327-5191

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5901 N LIDGERWOOD ST
Provider Second Line Business Practice Location Address:
SUITE 219
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99208-5095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-456-5733
Provider Business Practice Location Address Fax Number:
509-327-5191
Provider Enumeration Date:
05/21/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TUPPER
Authorized Official First Name:
TERI
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
509-456-5733

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)