Individual
JEREMY R BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 N GRAHAM ST., SUITE 201, PORTLAND, OR 97227-1682
(503) 413-4488
(503) 413-1812
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
82-163
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69988234
—
NM
Enumeration date
01/23/2006
Last updated
09/11/2015
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