Provider Demographics
NPI:1447258926
Name:HARPUR, TIMOTHY JOHN (BA,MA,PHD,MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOHN
Last Name:HARPUR
Suffix:
Gender:M
Credentials:BA,MA,PHD,MD
Other - Prefix:
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Mailing Address - Street 1:990 SYLVAN WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-2851
Mailing Address - Country:US
Mailing Address - Phone:360-479-3657
Mailing Address - Fax:360-373-7616
Practice Address - Street 1:990 SYLVAN WAY
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2851
Practice Address - Country:US
Practice Address - Phone:360-479-3657
Practice Address - Fax:360-373-7616
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00042513207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00077198OtherRAILROAD MEDICARE
WA0173317OtherLABOR AND INDUSTRIES
WA7215HAOtherREGENCE BLUE SHIELD
WA016487001OtherGROUP HEALTH CORP
WA910847215OtherUNIFORM MEDICAL
WA91084721535OtherKPS
WA8932749OtherVICTIMS OF CRIME
WA8366130Medicaid
WAA034OtherTRIWEST
WA910847215OtherPREMERA BLUE CROSS
WA910847215OtherUNIFORM MEDICAL
WAA034OtherTRIWEST