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Organization

RAYMOND A MILLETTE

Active
Other names
Millette Family Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARY K TAYLOR (OFFICE MANAGER)
(541) 471-9022
Entity
Organization

Contact information

Practice address
1014 NE 7TH ST, GRANTS PASS, OR 97526-1420
(541) 471-9022
(541) 471-9055
Mailing address
1014 NE 7TH ST, GRANTS PASS, OR 97526-1420
(541) 471-9022
(541) 471-9055

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
200550153
OR
363LF0000X
Family Nurse Practitioner
200550156
OR
363LF0000X
Family Nurse Practitioner
Primary
95000636
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
026845
OR
05
272449
OR
05
292050
OR
05
297670
OR
01
P00641991
RAILROAD MEDICARE
OR
01
P00655554
RAILROAD MEDICARE
OR
Enumeration date
11/14/2006
Last updated
05/28/2009
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