Clark, Timothy John
Clark, Timothy John is an sole proprietor health care provider with primary practice located at 17 Sw Frazer Ave Ste 282 , Pendleton OR 97801-0048. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is his primary health care specialty. Clark, Timothy John can be contacted via phone (541) 278-6330.Contact Information
Primary practice address
17 Sw Frazer Ave Ste 282
Pendleton OR 97801-0048
Phone: (541) 278-6330
Fax: (541) 278-5419
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | ||
| Other Service Providers / Peer Specialist | 175T00000X |
Profile Details
| NPI number | 1659810299 |
|---|---|
| LBN Legal business name | Clark, Timothy John |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 15th, 2017 |
| Last updated | Jan 29th, 2020 - about 5 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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