Healthcare Provider Details

I. General information

NPI: 1447259650
Provider Name (Legal Business Name): MURRAY DOUGLAS JOE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 DIVISION ST STE. 115
OREGON CITY OR
97045-1582
US

IV. Provider business mailing address

1508 DIVISION ST STE. 115
OREGON CITY OR
97045-1582
US

V. Phone/Fax

Practice location:
  • Phone: 503-656-0601
  • Fax: 503-656-1389
Mailing address:
  • Phone: 503-656-0601
  • Fax: 503-656-1389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number9660
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: