Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD-15425 | HI |
NPI | 1013229293 |
---|---|
Provider Name | Dr. Raymond Charles Ray |
First Address | Vancouver, WA 98683-9324 |
Second Address | Eugene, OR 97401-8122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2010 |
Last Update Date | 30/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500713469 | (05) | OR |