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Individual

DR. GREGORY L BEAGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-4830
(503) 216-4850
Mailing address
9400 SW BARNES RD, SUITE 307, PORTLAND, OR 97225-6608
(503) 292-9108
(503) 292-0346

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
18667
OR
2085R0202X
Diagnostic Radiology Physician
Primary
18667
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
064902
OR
Enumeration date
01/26/2006
Last updated
11/08/2019
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