John Edwad Timm Jr., EAMP

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC60539781 Issued in WA

Practice address

602 NE 3Rd Ave
Battle Ground, WA 98604-8145

Phone

(360) 624-1106

NPI assigned

Mar 2, 2015

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1851783732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 W MAIN ST",
            "address_2": "SUITE 110",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049830",
            "telephone_number": "360-624-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 NE 3RD AVE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986048145",
            "telephone_number": "360-624-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMM",
        "first_name": "JOHN",
        "middle_name": "EDWAD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "EAMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60539781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.