Provider Demographics
NPI:1174934608
Name:GALL, TIMOTHY RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:RICHARD
Last Name:GALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9040 JACKSON AVE NEUROLOGY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-396-8144
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE NEUROLOGY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-396-1440
Practice Address - Fax:253-968-0443
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012588252084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology