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Individual

JONATHAN DAVID BEAMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
103 S SAINT FRANCIS DR, STE C, SANTA FE, NM 87501-2458
(505) 466-4701
Mailing address
3439 NE SANDY BLVD, PMB 375, PORTLAND, OR 97232-1959
(503) 284-8841
(503) 282-3302

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
G63150
CA
2084P0800X
Psychiatry Physician
Primary
MD2005-0497
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
031018
OR
Enumeration date
05/05/2006
Last updated
02/28/2012
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