Provider Demographics
NPI:1821388745
Name:PIMENTEL, TIMOTHY CEMC (RN, CNOR, RNFA)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:CEMC
Last Name:PIMENTEL
Suffix:
Gender:M
Credentials:RN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10203 MERLIN WAY
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-8691
Mailing Address - Country:US
Mailing Address - Phone:541-892-0981
Mailing Address - Fax:
Practice Address - Street 1:10203 MERLIN WAY
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-8691
Practice Address - Country:US
Practice Address - Phone:541-892-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200641523RN163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant