Provider Demographics
NPI:1326419805
Name:MOREHOUSE, TIM J (HIS)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:J
Last Name:MOREHOUSE
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E NORTHERN LIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4133
Mailing Address - Country:US
Mailing Address - Phone:907-274-7700
Mailing Address - Fax:907-274-7710
Practice Address - Street 1:700 E NORTHERN LIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4133
Practice Address - Country:US
Practice Address - Phone:907-274-7700
Practice Address - Fax:907-274-7710
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK104458237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist