Provider Demographics
NPI:1154525970
Name:DUENAS, TIMOTHY STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:STEVEN
Last Name:DUENAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:890 OAK ST SE BLDG A
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3905
Mailing Address - Country:US
Mailing Address - Phone:503-561-5634
Mailing Address - Fax:503-814-1071
Practice Address - Street 1:890 OAK ST SE BLDG A
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3905
Practice Address - Country:US
Practice Address - Phone:503-561-5634
Practice Address - Fax:503-814-1071
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR8251207P00000X
ORMD151252207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine