Provider Demographics
NPI:1780670778
Name:SWINDLER, TIMOTHY JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOSEPH
Last Name:SWINDLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12728 SE STARK ST BLDG G
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-1539
Mailing Address - Country:US
Mailing Address - Phone:503-252-5097
Mailing Address - Fax:503-252-5297
Practice Address - Street 1:12728 SE STARK ST BLDG G
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-1539
Practice Address - Country:US
Practice Address - Phone:503-252-5097
Practice Address - Fax:503-252-5297
Is Sole Proprietor?:No
Enumeration Date:2005-09-25
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-3387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR75 3115541OtherTAX ID
OR823823000OtherBLUECROSS BLUE SHEILD
OR75 3115541OtherTAX ID