Healthcare Provider Details

I. General information

NPI: 1124006671
Provider Name (Legal Business Name): CHAD BYARS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 SE 32ND AVE
PORTLAND OR
97222-6516
US

IV. Provider business mailing address

9155 SW BARNES RD SUITE 420
PORTLAND OR
97225-6625
US

V. Phone/Fax

Practice location:
  • Phone: 503-513-1031
  • Fax: 503-513-8469
Mailing address:
  • Phone: 503-297-6334
  • Fax: 503-297-2360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35075203
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD27144
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: