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Individual

DR. RICHARD B ISMACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE CDW-EM, PORTLAND, OR 97239-3011

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD25393
OR
207R00000X
Internal Medicine Physician
MD25393
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00816483B
GA
05
041178
OR
05
8228769
WA
Enumeration date
06/09/2005
Last updated
03/03/2021
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