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NPI Code Detail

MEDICARE: DR. RAYLENE LORRAINE GORDIN M.D.

MEDICARE:  DR. RAYLENE LORRAINE GORDIN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianMD19742OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033282181
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYLENE LORRAINE GORDIN M.D.
Provider Business Mailing Address
First Line : 37686 KATHLEEN CT
Second Line :
City : LEBANON
State : OR
Zip : 97355-8832
Country : US
Telephone Number : 503-580-0761
Fax Number : 503-213-5948
Provider Business Practice Location Address
First Line : 1296 COMMERCIAL ST. SE
Second Line : SUITE 103
City : SALEM
State : OR
Zip : 97302-4200
Country : US
Telephone Number : 503-580-0761
Fax Number : 503-213-5948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 03/03/2021

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Directions to “ DR. RAYLENE LORRAINE GORDIN M.D.” Practice Location

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