Provider Demographics
NPI:1114253606
Name:FEARL, JAMES DOUGLAS (JAMES FEARL)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOUGLAS
Last Name:FEARL
Suffix:
Gender:M
Credentials:JAMES FEARL
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:DOUGLAS
Other - Last Name:FEARL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:15198 NW TROON WAY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-0931
Mailing Address - Country:US
Mailing Address - Phone:503-466-2988
Mailing Address - Fax:
Practice Address - Street 1:15198 NW TROON WAY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-0931
Practice Address - Country:US
Practice Address - Phone:503-466-2988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR66688207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology