Provider Demographics
NPI:1265803720
Name:BARTH, TODD
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:
Last Name:BARTH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15835 SW BOBWHITE CIR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-8228
Mailing Address - Country:US
Mailing Address - Phone:503-530-1527
Mailing Address - Fax:
Practice Address - Street 1:1400 NE 48TH AVE STE 107
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5017
Practice Address - Country:US
Practice Address - Phone:501-353-0152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR152286376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker