Provider Demographics
NPI:1962737320
Name:WALTER, TIMOTHY OTTO (ND)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:OTTO
Last Name:WALTER
Suffix:
Gender:M
Credentials:ND
Other - Prefix:DR
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:WALTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:151 W 7TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2676
Mailing Address - Country:US
Mailing Address - Phone:541-682-3550
Mailing Address - Fax:541-682-6703
Practice Address - Street 1:151 W 7TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2676
Practice Address - Country:US
Practice Address - Phone:541-682-3550
Practice Address - Fax:541-682-6703
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1751175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath