MEDICARE: TIMOTHY JAMES TREIBLE MD

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	207X00000X	Orthopaedic Surgery Physician	MD15152	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0071885	OTHER	WA	WA LABOR INDUSTRY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669454997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY JAMES TREIBLE MD

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	11/05/2007

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