Brian Andrew Timm, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA150327 Issued in OR

Practice address

2222 NW Lovejoy St
Suite 315
Portland, OR 97210-3033

Phone

(503) 226-6321

Fax

(503) 227-3422

NPI assigned

Oct 13, 2009

Last updated

Jul 27, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Oregon Clinic PC

  • Specialist
  • Portland, OR
  • NPI 1265417174
  NPD (past)
• The Oregon Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1346105129
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1144555988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 SE SANDY BLVD",
            "address_2": "SUITE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141308",
            "telephone_number": "503-236-0775",
            "fax_number": "503-236-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "address_2": "SUITE 315",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103033",
            "telephone_number": "503-226-6321",
            "fax_number": "503-227-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMM",
        "first_name": "BRIAN",
        "middle_name": "ANDREW",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-13",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA150327",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60121081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8557449",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timber Dental Bethany
• Timber Dental Downtown LLC
• Timber Dental East Burnside
• Timber Dental LLC (Timber Dental)
• Gabriel Time, PA
• Nicole L Timm
• Kavya Timmireddy, MD
• Bailey Timmons, MD
• Tamara Timmons, M.D.
• Alyssa Timon, LMT

• Surgical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.