Provider Demographics
NPI:1073582359
Name:DENMAN, TIMOTHY M (MD)
Entity Type:Individual
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First Name:TIMOTHY
Middle Name:M
Last Name:DENMAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6420 SW MACADAM AVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3507
Mailing Address - Country:US
Mailing Address - Phone:503-244-8601
Mailing Address - Fax:503-244-3013
Practice Address - Street 1:4035 MERCANTILE DR
Practice Address - Street 2:SUITE 216
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2546
Practice Address - Country:US
Practice Address - Phone:503-636-2551
Practice Address - Fax:503-636-3055
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2013-05-29
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Provider Licenses
StateLicense IDTaxonomies
ORMD09153207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR180022040OtherRAILROAD MEDICARE
OR04877-7Medicaid
OR018WCQKSAMedicare PIN
ORC92504Medicare UPIN