Provider Demographics
NPI:1376062794
Name:HILTON, TIMOTHY I (APRN-C)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:I
Last Name:HILTON
Suffix:
Gender:M
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2298 NW KINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3923
Mailing Address - Country:US
Mailing Address - Phone:541-368-5986
Mailing Address - Fax:866-624-8745
Practice Address - Street 1:388 STATE ST STE 420
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3581
Practice Address - Country:US
Practice Address - Phone:541-368-5986
Practice Address - Fax:866-624-8745
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2272748363LG0600X
TX1027411363LG0600X
OR10017536363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN2272748OtherLICENSE