MEDICARE: DR. TIMOTHY MICHAEL BECKER DO

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	207R00000X	Internal Medicine Physician	DO199096	OR
2	207UN0901X	Nuclear Cardiology Physician	DO199096	OR
3	207RC0000X	Cardiovascular Disease Physician	DO199096	OR

General Provider Information

NPI Number	:	1740619055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY MICHAEL BECKER DO

Provider Business Mailing Address
First Line	:	3181 SW SAM JACKSON PARK RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3011
Country	:	US
Telephone Number	:	503-494-7400
Fax Number	:	503-494-4794

Provider Business Practice Location Address
First Line	:	2095 EXCHANGE ST STE 301
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-3400
Country	:	US
Telephone Number	:	503-338-4087
Fax Number	:	503-338-4091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	07/31/2020

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