Timothy Alan Trautman, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

81001709 Issued in OR

Practice address

1120 Mill St.
Suite 2
Waldport, OR 97394-0461

Phone

(541) 563-5080

Fax

(541) 563-5090

NPI assigned

Mar 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689798118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 461",
            "address_2": "1120 MILL ST. SUITE 2",
            "city": "WALDPORT",
            "state": "OR",
            "postal_code": "973940461",
            "telephone_number": "541-563-5080",
            "fax_number": "541-563-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 MILL ST.",
            "address_2": "SUITE 2",
            "city": "WALDPORT",
            "state": "OR",
            "postal_code": "973940461",
            "telephone_number": "541-563-5080",
            "fax_number": "541-563-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUTMAN",
        "first_name": "TIMOTHY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "81001709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samaritan Pacific Health Services, Inc. (Samaritan Health Clinic - Waldport)
• Sound Achievement, LLC
• Edward Taylor, P.A.C.
• Gary Lee Thueson, M.D.
• Angella A Tiger
• Catherine Michelle Vallejo, LABOR DOULA
• Lee A. Vogelman, D.O.
• Waldport Eye Care LLC
• Joan Grier Wikler, M.D.
• Jennifer L. Wrazen, M.D., FAAP

• Adult Health Nurse Practitioner in Waldport, OR
• Providers in Waldport, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.