Cleary, Timothy S

Cleary, Timothy S is an sole proprietor health care provider with primary practice located at 11786 Sw Barnes Rd Ste 270, Portland OR 97225-5929. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Cleary, Timothy S can be contacted via phone (503) 520-0777.

Contact Information

Primary practice address
11786 Sw Barnes Rd Ste 270 Portland OR 97225-5929
Phone: (503) 520-0777
Fax: (503) 520-0559
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 13852 Oregon

Profile Details

NPI number 1215933411
LBN Legal business name Cleary, Timothy S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2005
Last updated Dec 17th, 2008 - about 17 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 1215933411 NPPES
Oregon MEDICAID 109009
Oregon Other P00156415

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