Individual
JOSHUA RAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15640 NW LAIDLAW RD, SUITE 102, PORTLAND, OR 97229-3828
(503) 764-0100
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD166934
OR
390200000X
Student in an Organized Health Care Education/Training Program
PENDING
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500667021
—
OR
Enumeration date
06/07/2011
Last updated
06/21/2021
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