O'Brien, Timothy J

O'Brien, Timothy J is an individual health care provider with primary practice located at 700 E Manitoba Ave Suite 109, Ellensburg WA 98926-3885. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Other Service Providers / Specialist is his primary health care specialty. O'Brien, Timothy J can be contacted via phone (509) 925-6947.

Contact Information

Primary practice address
700 E Manitoba Ave Suite 109 Ellensburg WA 98926-3885
Phone: (509) 925-6947
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD00021680 Washington
Allopathic & Osteopathic Physicians / Surgery 208600000X MD00021680 Washington

Profile Details

NPI number 1770506453
LBN Legal business name O'Brien, Timothy J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated May 10th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770506453 NPPES
Washington MEDICAID 7010614

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