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Individual

PETER JAY BEAMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
8638 N LOMBARD ST STE 3A, PORTLAND, OR 97203-3741
(503) 386-1972
Mailing address
9707 N CLARENDON AVE, PORTLAND, OR 97203-1917
(503) 849-8320

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
163WE0003X
Emergency Registered Nurse
201041505
OR

Other

Enumeration date
06/27/2022
Last updated
06/27/2022
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