Provider Demographics
NPI:1710151485
Name:MCGLASSON, TIMOTHY JAMES (ARNP)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:MCGLASSON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 BELLEVUE WAY NE
Mailing Address - Street 2:UNIT D
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3600
Mailing Address - Country:US
Mailing Address - Phone:512-750-5927
Mailing Address - Fax:
Practice Address - Street 1:1402 BELLEVUE WAY NE
Practice Address - Street 2:UNIT D
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3600
Practice Address - Country:US
Practice Address - Phone:512-750-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00166655163WP0809X
WAAP60077960363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult