MEDICARE: BENJAMIN THOMAS FEENEY M.D.

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	208600000X	Surgery Physician	MD70071206	WA
2	208600000X	Surgery Physician	MD218258	OR
3	208600000X	Surgery Physician	A158678	CA

General Provider Information

NPI Number	:	1992020754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN THOMAS FEENEY M.D.

Provider Business Mailing Address
First Line	:	541 NE 20TH AVE STE 225
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-2895
Country	:	US
Telephone Number	:	503-963-2801
Fax Number	:	503-963-2825

Provider Business Practice Location Address
First Line	:	5050 NE HOYT ST STE 651
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97213-2954
Country	:	US
Telephone Number	:	503-935-8700
Fax Number	:	503-935-8701

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

Provider Enumeration Date	:	04/05/2010
Last Update Date	:	12/16/2025

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