MEDICARE: DR. ERIC A DOWNEY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	D7897	OR

General Provider Information

NPI Number	:	1770584419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC A DOWNEY DDS

Provider Business Mailing Address
First Line	:	14795 SW MURRAY SCHOLLS DR
Second Line	:	SUITE 116
City	:	BEAVERTON
State	:	OR
Zip	:	97007-9713
Country	:	US
Telephone Number	:	503-579-0304
Fax Number	:	503-579-7866

Provider Business Practice Location Address
First Line	:	14795 SW MURRAY SCHOLLS DR
Second Line	:	SUITE 116
City	:	BEAVERTON
State	:	OR
Zip	:	97007-9713
Country	:	US
Telephone Number	:	503-579-0304
Fax Number	:	503-579-7866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/08/2007

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