Individual ProviderTimothy LundSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371(503) 234-9591PECOS EnrollmentBased on the most recent information from CMS, provider Timothy Lund does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1124477989Provider TypeIndividualFull NameLund, TimothyGenderMaleSole ProprietorNoEnumeration Date6/11/2016Last Updated6/11/2016Contact InformationPractice LocationPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371Phone(503) 234-9591FaxUnlisted FaxMailing LocationMailing Address3415 SE Powell Blvd, Portland, OR 97202-3371Phone(503) 234-9591FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer