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NPI Code Detail

MEDICARE: TIMOTHY J TREIBLE MD PC

MEDICARE: TIMOTHY J TREIBLE MD PC
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
1207X00000XOrthopaedic Surgery Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CH1163OTHERRR MEDICARE

General Provider Information

NPI Number : 1518941525
Entity Type Code : Organization
Provider Name (Legal Business Name) : TIMOTHY J TREIBLE MD PC
Provider Business Mailing Address
First Line : 135 NE 102ND AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97220-4167
Country : US
Telephone Number : 503-255-5388
Fax Number : 503-255-5085
Provider Business Practice Location Address
First Line : 135 NE 102ND AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97220-4167
Country : US
Telephone Number : 503-255-5388
Fax Number : 503-255-5085
Authorized Official
Title or Position : OWNER
Name : TIMOTHY JAMES TREIBLE
Credential : MD PC
Telephone Number : 503-255-5388
Provider Enumeration Date : 12/02/2005
Last Update Date : 02/22/2008

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