Individual
DR. MARTIN N RAITIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9900 SW WILSHIRE ST, SUITE 220, PORTLAND, OR 97225-5035
(503) 292-4538
(503) 292-2560
Mailing address
PO BOX 87670, VANCOUVER, WA 98687-7670
(360) 263-5420
(360) 263-5406
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16244
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043380
—
OR
01
—
083172000
BLUE CROSS/BLUE SHIELD
OR
Enumeration date
08/31/2006
Last updated
07/08/2007
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