NPI 1003535386

Tim Ray Kelly

Practitioner Peer Specialist Lincoln City, OR

Practice location

Address: 1221 NW Highway 101 STE a, Lincoln City, OR 97367-3351
Phone: (442) 244-1336

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence THW000106995 (OR)

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Registry record

NPI: 1003535386
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Aug 2022
Record last updated: 22 Aug 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.