Provider Demographics
NPI:1447835558
Name:TIMBERVIEW FAMILY PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:TIMBERVIEW FAMILY PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:406-396-5764
Mailing Address - Street 1:PO BOX 7293
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59807-7293
Mailing Address - Country:US
Mailing Address - Phone:406-396-5764
Mailing Address - Fax:
Practice Address - Street 1:2825 STOCKYARD RD STE A15
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1545
Practice Address - Country:US
Practice Address - Phone:406-201-7142
Practice Address - Fax:406-201-7070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)