Provider Demographics
NPI:1063461861
Name:BARR, IAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:L
Last Name:BARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15455 NW GREENBRIER PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7374
Mailing Address - Country:US
Mailing Address - Phone:503-629-5499
Mailing Address - Fax:503-645-8982
Practice Address - Street 1:15455 NW GREENBRIER PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7374
Practice Address - Country:US
Practice Address - Phone:503-629-5499
Practice Address - Fax:503-645-8982
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR9667207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR016741OtherOMAP
OR016741OtherOMAP
OR016741OtherOMAP
OR930710414OtherTIN