| Doctor Name: | MR. TIMOTHY ALAN TRAUTMAN |
| NPI Number: | 1689798118 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ANP |
| License Number: | 81001709 |
| Business Practice Address: | 1120 Mill St. Suite 2 Waldport, OR - 973940461 |
| Business Phone Number: | 5415635080 |
| Business Fax Number: | 5415635090 |
| Mailing Address: | Po Box 461, 1120 Mill St. Suite 2 WALDPORT |
| State: | OR |
| Postal Code: | 973940461 |
| Phone Number: | 5415635080 |
| Fax Number: | 5415635090 |
| NPI Enumeration Date: | 03/19/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 81001709 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |