1528501806 NPI number — CARRIE ANNE RAYMOND PT, C/NDT, CLT

Table of content: CARRIE ANNE RAYMOND PT, C/NDT, CLT (NPI 1528501806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528501806 NPI number — CARRIE ANNE RAYMOND PT, C/NDT, CLT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAYMOND
Provider First Name:
CARRIE
Provider Middle Name:
ANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, C/NDT, CLT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528501806
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
815 NW 9TH ST
Provider Second Line Business Mailing Address:
SUITE180
Provider Business Mailing Address City Name:
CORVALLIS
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97330-6173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-768-5157
Provider Business Mailing Address Fax Number:
541-768-5080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
815 NW 9TH ST
Provider Second Line Business Practice Location Address:
SUITE180
Provider Business Practice Location Address City Name:
CORVALLIS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97330-6173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-768-5157
Provider Business Practice Location Address Fax Number:
541-768-5080
Provider Enumeration Date:
11/18/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  60282 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com