Provider Demographics
NPI:1033705157
Name:TIMONEN, DAVID MICHAEL (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:TIMONEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2944 COUNTY ROAD 139
Mailing Address - Street 2:
Mailing Address - City:BARNUM
Mailing Address - State:MN
Mailing Address - Zip Code:55707-8858
Mailing Address - Country:US
Mailing Address - Phone:218-380-1887
Mailing Address - Fax:
Practice Address - Street 1:2944 COUNTY ROAD 139
Practice Address - Street 2:
Practice Address - City:BARNUM
Practice Address - State:MN
Practice Address - Zip Code:55707-8858
Practice Address - Country:US
Practice Address - Phone:218-380-1887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1178381835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist