Peters, Timothy James

Peters, Timothy James is an individual health care provider with primary practice located at 5200 Sw Macadam Ave #580, Portland OR 97239-3837. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Peters, Timothy James can be contacted via phone (503) 231-7854.

Contact Information

Primary practice address
5200 Sw Macadam Ave #580 Portland OR 97239-3837
Phone: (503) 231-7854
Fax: (503) 231-8153
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X LW00008136 Washington
Behavioral Health & Social Service Providers / Social Worker 104100000X L3666 Oregon

Profile Details

NPI number 1770541138
LBN Legal business name Peters, Timothy James
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Dec 28th, 2021 - about 3 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 1770541138 NPPES
Oregon MEDICAID 278487

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