Buckley, Theresa M
Buckley, Theresa M is an individual health care provider with primary practice located at 10201 Se Main St Ste 29 , Portland OR 97216-2937. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Sleep Medicine is her primary health care specialty. Buckley, Theresa M can be contacted via phone (503) 261-4475.Contact Information
Primary practice address
10201 Se Main St Ste 29
Portland OR 97216-2937
Phone: (503) 261-4475
Fax: (503) 261-4476
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Sleep Medicine | 2084S0012X | MD28008 | Oregon |
Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | MD28008 | Oregon |
Profile Details
NPI number | 1831283597 |
---|---|
LBN Legal business name | Buckley, Theresa M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 3rd, 2006 |
Last updated | Apr 12th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1831283597 | NPPES |
Oregon | MEDICAID | 007192 | |
Oregon | MEDICAID | 00A679360 |
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