Buckley, Theresa M

Buckley, Theresa M is an individual health care provider with primary practice located at 10201 Se Main St Ste 29 , Portland OR 97216-2937. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Sleep Medicine is her primary health care specialty. Buckley, Theresa M can be contacted via phone (503) 261-4475.

Contact Information

Primary practice address
10201 Se Main St Ste 29 Portland OR 97216-2937
Phone: (503) 261-4475
Fax: (503) 261-4476
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sleep Medicine 2084S0012X MD28008 Oregon
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD28008 Oregon

Profile Details

NPI number 1831283597
LBN Legal business name Buckley, Theresa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Apr 12th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831283597 NPPES
Oregon MEDICAID 007192
Oregon MEDICAID 00A679360

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