TIMOTHY MATHER BROWN (NPI# 1417058082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417058082 |
| Entity Type | Individual |
| Full Name | TIMOTHY MATHER BROWN |
| Credential | MD |
| Practice Address |
12612 Se Stark St Portland OR 97233-1058 |
| Practice Telephone | 5032576393 |
| Practice Fax Number | 5032578785 |
| Mailing Telephone | 5032576393 |
| Mailing Fax Number | 5032578785 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2013-10-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD12786 | OR | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
MD12786 | OR | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD12786 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE RAILROAD | 070008378 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700351491 | Timothy Brown | Home Health Aide | 6128 W Shara Ave, Las Vegas, NV 89146-3051 | 2018-10-09 |
| 1437605458 | Timothy Brown | Counselor | 2750 Virginia Pkwy Ste 104, Mckinney, TX 75071-4971 | 2016-08-30 |
| 1972887859 | Timothy Brad Brown | Pharmacist | 360 S Alabama Ave, Monroeville, AL 36460-1806 | 2011-10-10 |
| 1881972487 | Timothy Alan Brown | Pharmacist | 1775 Village Center Cir Ste 190, Las Vegas, NV 89134-0571 | 2011-07-30 |
| 1114216827 | Timothy Brown | Physical Therapist | 2311 Cottman Ave, Philadelphia, PA 19149-1007 | 2011-04-04 |
| 1225277288 | Timothy Allen Brown | Counselor | 141 Reservoir Ave, Providence, RI 02907-3401 | 2009-02-16 |
| 1659529949 | Timothy Gerard Brown | Social Worker | 138 N. Court St, Wampsville, NY 13163 | 2008-08-29 |
| 1740444702 | Timothy Martel Brown | Social Worker | 1209b Baker Ave, Bryan, TX 77803-4726 | 2008-07-17 |
| 1598983348 | Timothy Paul Brown | Psychiatry & Neurology | Walter Reed Army Medical Center, Dept of Psychiatry, 6900 Georgia Ave Nw, Bldg. 6, Borden Pavilion, Washington, DISTRICT OF COLUMBIA 20307 | 2007-04-24 |
| 1235263518 | Timothy Charles Brown | Dentist | 3309 Healy Dr Ste B, Winston Salem, NC 27103-1474 | 2007-03-16 |
| Street Address |
12612 SE STARK ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-1058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508303561 | Carter Kroeplin Haag | Dermatology | 3303 S Bond Ave # 16d, Portland, OR 97239-4501 | 2017-01-27 |
| 1043765134 | Noelle Teske | Dermatology | 3303 S Bond Ave Fl 16, Portland, OR 97239-4501 | 2016-08-18 |
| 1134579535 | Caroline Morris | Dermatology | 3303 S Bond Ave # Chh16d, Portland, OR 97239-4501 | 2016-06-16 |
| 1033539184 | Natasha Fewkes Carter | Dermatology | 4914 Sw 1st Ave, Portland, OR 97239-2883 | 2014-04-16 |
| 1538588504 | Elizabeth Berry | Dermatology | Ohsu Department of Dermatology, 3303 Sw Bond Ave Ch 16d, Portland, OR 97239-4501 | 2014-04-07 |
| 1124250584 | Einar Axel Juhlin | Dermatology | 340 Eastern Promenade, Unit 154, Portland, ME 04101-2754 | 2009-08-19 |
| 1902040777 | Rajan P Kulkarni | Dermatology | 3303 Sw Bond Ave Ste 16, Portland, OR 97239 | 2009-04-23 |
| 1124280540 | Omar N Qutub | Dermatology | 1129 Nw 11th Ave, Portland, OR 97209-3469 | 2008-06-26 |
| 1285891168 | Stacy Nicole Reed | Dermatology | 13305 Nw Cornell Rd Ste C, Portland, OR 97229-5987 | 2008-05-19 |
| 1427243591 | Robert Bickford Amon | Dermatology | 1700 Sw Broadway Dr, Portland, OR 97201-2211 | 2007-09-11 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.