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Individual

DOUGLAS E RAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
4104 SE 82ND AVE, SUITE 250, PORTLAND, OR 97266-2954
(503) 215-9850
(503) 215-9855
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
087000130N1
OR
363LF0000X
Family Nurse Practitioner
087000130N1 FNP-PP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
060637
OR
05
139449
OR
Enumeration date
10/31/2006
Last updated
10/12/2012
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