Provider Demographics
NPI:1124514823
Name:PARSONS, TIMOTHY CRAIG (RN)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:CRAIG
Last Name:PARSONS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 SE ALDER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-3015
Mailing Address - Country:US
Mailing Address - Phone:503-807-1535
Mailing Address - Fax:
Practice Address - Street 1:2727 SE ALDER ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-3015
Practice Address - Country:US
Practice Address - Phone:503-807-1535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201242436RN163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management