Provider Demographics
NPI:1669249439
Name:SANDERS, TIMOTHY SCOTT (DC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:SANDERS
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 1:1900 NE DIVISION ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3572
Mailing Address - Country:US
Mailing Address - Phone:541-316-0237
Mailing Address - Fax:
Practice Address - Street 1:1900 NE DIVISION ST STE 206
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3572
Practice Address - Country:US
Practice Address - Phone:541-316-0237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6343111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor