# CLEARY MEDICAL ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639175813
- **Authorized official:** TIMOTHY SHANNAHAN CLEARY MD (SOLE MEMBER)
- **Authorized official phone:** (503) 520-0777

## Contact information

- **Practice address:** 11786 SW BARNES RD, STE 270, PORTLAND, OR 97225-5929
- **Practice address phone:** (503) 520-0777
- **Practice address fax:** (503) 520-0559
- **Mailing address:** PO BOX 23200, PORTLAND, OR 97281-3200
- **Mailing address phone:** (503) 520-0777
- **Mailing address fax:** (503) 520-0559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 13852 | OR | Yes |

## Other

- **Enumeration date:** 06/22/2005
- **Last updated:** 10/16/2007