Provider Demographics
NPI:1336152883
Name:TWOMBLY, DANIEL CAVANAGH (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CAVANAGH
Last Name:TWOMBLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2501 NW 229TH AVE
Mailing Address - Street 2:RA3-113 INTEL
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5506
Mailing Address - Country:US
Mailing Address - Phone:971-214-8422
Mailing Address - Fax:971-214-8607
Practice Address - Street 1:2501 NW 229TH AVE
Practice Address - Street 2:RA3-113 INTEL
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5506
Practice Address - Country:US
Practice Address - Phone:971-214-8422
Practice Address - Fax:971-214-8607
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2011-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD15684207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8124885Medicaid
OR021878Medicaid
131654OtherMEDICARE
OR021878Medicaid