Look up the most recent NPI and PECOS records

Ethan Beckley

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

3181 SW Sam Jackson Park Rd, Ohsu, Portland, OR 97239-3011

PECOS Enrollment

Based on the most recent information from CMS, provider Ethan Beckley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1184064842
Provider Type
Individual
Full Name
Beckley, Ethan
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/26/2013
Last Updated
2/22/2022

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Ohsu, Portland, OR 97239-3011

(503) 494-8220

Unlisted Fax

Mailing Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD182869 Oregon

Ethan Beckley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Batuman, Cem

Yousuf, Sameer Syed

Brown, Nicolas Dmitri

Walker, Roger Dale

Beckman, Morgyn

Matteucci, Neil Arthur

Rodriguez, Mikaela Lea

Keepers, George Alan

Collumb, Elizabeth Kathleen

Griebeler, Meridith Amanda