MEDICARE: DR. RICHARD J BARSOTTI MD

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
1	208000000X	Pediatrics Physician	MD13024	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1023010428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD J BARSOTTI MD

Provider Business Mailing Address
First Line	:	15455 NW GREENBRIER PKWY
Second Line	:	STE 112
City	:	BEAVERTON
State	:	OR
Zip	:	97006-7374
Country	:	US
Telephone Number	:	503-466-1668
Fax Number	:	503-439-6194

Provider Business Practice Location Address
First Line	:	9300 SE 91ST AVE STE 200
Second Line	:
City	:	HAPPY VALLEY
State	:	OR
Zip	:	97086-3762
Country	:	US
Telephone Number	:	503-261-1171
Fax Number	:	503-253-5989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	03/04/2014

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