Individual
DONALD R GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
342 FAIRVIEW ST, SILVERTON, OR 97381-1917
(503) 873-1690
Mailing address
127 DEL PRADO ST, LAKE OSWEGO, OR 97035-1313
(503) 680-6450
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
0101048920
VA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD10678
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010056161
—
VA
05
—
238246
—
OR
Enumeration date
06/14/2006
Last updated
12/26/2008
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