Organization
MARTIN N RAITIERE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN N RAITIERE MD (SOLE PROVIDER/PRESIDENT)
(503) 292-4538
Entity
Organization
Contact information
Practice address
9900 SW WILSHIRE ST, STE 220, PORTLAND, OR 97225-5035
(503) 292-4538
(503) 292-2560
Mailing address
PO BOX 87670, VANCOUVER, WA 98687-7670
(503) 292-4538
(503) 292-2560
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16244
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043380
—
OR
Enumeration date
10/15/2010
Last updated
10/15/2010
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