Individual
DR. RICHARD W FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 NW LARCH AVE, STE 2, REDMOND, OR 97756-1186
(541) 548-3153
(541) 548-3376
Mailing address
813 SW HIGHLAND AVE, STE 101, REDMOND, OR 97756-3103
(541) 548-3153
(541) 548-3376
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD23347
OR
2083P0901X
Public Health & General Preventive Medicine Physician
MD23347
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124056494
NPI
OR
05
—
287298
—
OR
Enumeration date
06/28/2006
Last updated
07/10/2019
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