Black, Timothy

Black, Timothy is an individual health care provider with primary practice located at 200 Ne Mother Joseph Pl Suite 110, Vancouver WA 98664. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Black, Timothy can be contacted via phone (360) 254-6161.

Contact Information

Primary practice address
200 Ne Mother Joseph Pl Suite 110 Vancouver WA 98664
Phone: (360) 254-6161
Fax: (360) 449-1146
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60650228 Washington
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X Washington

Profile Details

NPI number 1730167271
LBN Legal business name Black, Timothy
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Aug 7th, 2018 - about 6 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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