Provider Demographics
NPI:1194948158
Name:BACHMAN, TIM (DMD)
Entity type:Individual
Prefix:DR
First Name:TIM
Middle Name:
Last Name:BACHMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 STRANDER BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2959
Mailing Address - Country:US
Mailing Address - Phone:206-394-7668
Mailing Address - Fax:
Practice Address - Street 1:411 STRANDER BLVD STE 205
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2959
Practice Address - Country:US
Practice Address - Phone:206-394-7668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA77381223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics