Provider Demographics
NPI:1437576410
Name:BEALS, TIMOTHY RYAN (DO)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:RYAN
Last Name:BEALS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 SW CHILDS RD
Mailing Address - Street 2:#B
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224
Mailing Address - Country:US
Mailing Address - Phone:503-692-8700
Mailing Address - Fax:503-692-8710
Practice Address - Street 1:7300 SW CHILDS RD
Practice Address - Street 2:#B
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224
Practice Address - Country:US
Practice Address - Phone:503-692-8700
Practice Address - Fax:503-692-8710
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR167652208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice