Provider Demographics
NPI:1972544435
Name:RAYMOND, ROBERT CRAIG (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CRAIG
Last Name:RAYMOND
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 1:1001 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-7485
Mailing Address - Country:US
Mailing Address - Phone:503-537-1785
Mailing Address - Fax:503-537-1809
Practice Address - Street 1:1001 PROVIDENCE DR
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-7485
Practice Address - Country:US
Practice Address - Phone:503-537-1785
Practice Address - Fax:503-537-1809
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24140207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR025349016OtherBSOR
OR286458Medicaid
OR286458Medicaid
ORR131334Medicare PIN