Provider Demographics
NPI:1003881681
Name:MURPHY, TIMOTHY DENNIS
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:DENNIS
Last Name:MURPHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:SUITE 212
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4252
Mailing Address - Country:US
Mailing Address - Phone:253-383-5777
Mailing Address - Fax:
Practice Address - Street 1:316 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:SUITE 212
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4252
Practice Address - Country:US
Practice Address - Phone:253-383-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050266L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001435129Medicaid
PA001435129Medicaid
PA102702EB0Medicare ID - Type Unspecified