Cleary Medical Associates, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13852 Issued in OR

Legal business name

CLEARY MEDICAL ASSOCIATES, LLC

Practice address

11786 SW Barnes Rd
Ste 270
Portland, OR 97225-5929

Phone

(503) 520-0777

Fax

(503) 520-0559

NPI assigned

Jun 22, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy Shannahan Cleary, MD

Title

Sole Member

Phone

(503) 520-0777

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1639175813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972813200",
            "telephone_number": "503-520-0777",
            "fax_number": "503-520-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11786 SW BARNES RD",
            "address_2": "STE 270",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255929",
            "telephone_number": "503-520-0777",
            "fax_number": "503-520-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARY MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "CLEARY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "SHANNAHAN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "503-520-0777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "13852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109009",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clear Path Counseling, LLC
• Clear Path Medical Transportation LLC
• Clear Path Treatment Services, LLC
• Clear Pathway Living LLC
• Clearwater Associates, LLC
• Bradford Alan Cleary, LMT
• Daniel R Cleary
• Joshua Michael Cleary, DNP, PMHNP-BC
• Lauren E Cleary, LPC, ATR-BC
• Leasia Marie Cleary, LCSW

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.