Healthcare Provider Details

I. General information

NPI: 1194774547
Provider Name (Legal Business Name): PATRICK J O'LEARY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 SE 8TH AVE SUITE 301A
HILLSBORO OR
97123-4253
US

IV. Provider business mailing address

364 SE 8TH AVE SUITE 301A
HILLSBORO OR
97123-4253
US

V. Phone/Fax

Practice location:
  • Phone: 503-681-4310
  • Fax: 503-681-1989
Mailing address:
  • Phone: 503-681-4310
  • Fax: 503-681-1989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA83444
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD27751
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: