Individual
TIMOTHY S CLEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11786 SW BARNES RD, STE 270, PORTLAND, OR 97225-5929
(503) 520-0777
(503) 520-0559
Mailing address
11786 SW BARNES RD, STE 270, PORTLAND, OR 97225-5929
(503) 520-0777
(503) 520-0559
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13852
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109009
—
OR
01
—
P00156415
RAILROAD MEDICARE
OR
Enumeration date
06/22/2005
Last updated
12/17/2008
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