Tim Charles Foulke, pmhnp
Nurse Practitioner, Psych/Mental Health in Portland, OR. Individual provider (NPI-1).
NPI number1265572937
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1265572937
- Entity type
- Individual (NPI-1)
- Name
- Tim Charles Foulke
- Credential
- pmhnp
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 8, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 080045508n6 | OR | Yes |
Practice location
2015 Ne 39th AvePortland, OR 97212-5305
Phone 503-422-3253 · Fax 503-281-0052
Mailing address
2434 Ne 36th AvePortland, OR 97212-5241
Phone 503-284-8372
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