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NPI Code Detail

MEDICARE: DR. MAURICE ERNEST GIRAUDIER M.D.

MEDICARE: DR. MAURICE ERNEST GIRAUDIER 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
12085R0202XDiagnostic Radiology PhysicianMD11540OR
22085R0202XDiagnostic Radiology PhysicianMD00018055WA

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 : 1528171303
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAURICE ERNEST GIRAUDIER M.D.
Provider Business Mailing Address
First Line : 3500 N INTERSTATE AVE
Second Line : KAISER PERMANENTE INTERSTATE MEDICAL OFFICE S
City : PORTLAND
State : OR
Zip : 97227-1196
Country : US
Telephone Number : 503-285-9321
Fax Number :
Provider Business Practice Location Address
First Line : 3500 NORTH INTERSTATE AVE
Second Line : INTERSTATE MEDICAL OFFICE SOUTH
City : PORTLAND
State : OR
Zip : 97227-1196
Country : US
Telephone Number : 503-331-6154
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 07/12/2007

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