Provider Demographics
NPI:1659547677
Name:BEITINJANEH, BASSEL (MD)
Entity Type:Individual
Prefix:DR
First Name:BASSEL
Middle Name:
Last Name:BEITINJANEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4984 SW OLESON RD
Mailing Address - Street 2:27
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1462
Mailing Address - Country:US
Mailing Address - Phone:314-484-0662
Mailing Address - Fax:
Practice Address - Street 1:4984 SW OLESON RD
Practice Address - Street 2:27
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1462
Practice Address - Country:US
Practice Address - Phone:314-484-0662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101275319207RC0001X
MO2008018537208M00000X
390200000X
OR2008018537208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program