Provider Demographics
NPI:1700869484
Name:BRINKER, TIMOTHY OBERLIN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:OBERLIN
Last Name:BRINKER
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16083 SW UPPER BOONES FERRY RD
Mailing Address - Street 2:STE 300
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7736
Mailing Address - Country:US
Mailing Address - Phone:800-219-8835
Mailing Address - Fax:503-639-9699
Practice Address - Street 1:5880 NE CORNELL RD
Practice Address - Street 2:STE C
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9075
Practice Address - Country:US
Practice Address - Phone:503-844-9294
Practice Address - Fax:503-615-0212
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2492225100000X
WAPT00007395225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR119854Medicaid
OR650014012OtherRR MEDICARE
OR650014012OtherRR MEDICARE