Healthcare Provider Details

I. General information

NPI: 1861447641
Provider Name (Legal Business Name): RAYMOND E WESTERMEYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 TWIN OAKS AVE SUITE #A-1
LEBANON OR
97355-2864
US

IV. Provider business mailing address

55 TWIN OAKS AVE SUITE #A-1
LEBANON OR
97355-2864
US

V. Phone/Fax

Practice location:
  • Phone: 541-451-6920
  • Fax: 541-451-6924
Mailing address:
  • Phone: 541-451-6920
  • Fax: 541-451-6924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD11419
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: