MEDICARE: AIRE MEDICAL

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	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number	:	1295589018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIRE MEDICAL

Provider Business Mailing Address
First Line	:	3990 CHERRY AVE NE STE 100
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303-4888
Country	:	US
Telephone Number	:	503-409-1204
Fax Number	:

Provider Business Practice Location Address
First Line	:	3990 CHERRY AVE NE STE 100
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303-4888
Country	:	US
Telephone Number	:	503-409-1204
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL J. CLINE
Credential	:	SI
Telephone Number	:	503-409-1204

Provider Enumeration Date	:	04/17/2024
Last Update Date	:	04/17/2024

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Directions to “AIRE MEDICAL ” Practice Location

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