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NPI Code Detail

MEDICARE: CHRISTOPHER WRAY EDWARDSON MD

MEDICARE: CHRISTOPHER WRAY EDWARDSON 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
1207Q00000XFamily Medicine PhysicianMD13699OR

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 : 1689667560
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER WRAY EDWARDSON MD
Provider Business Mailing Address
First Line : PO BOX 1517
Second Line :
City : PENDLETON
State : OR
Zip : 97801-0410
Country : US
Telephone Number : 877-708-1119
Fax Number : 541-278-8349
Provider Business Practice Location Address
First Line : 531 SE CLAY ST
Second Line :
City : DALLAS
State : OR
Zip : 97338-2865
Country : US
Telephone Number : 971-612-6100
Fax Number : 971-612-6101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 09/10/2021

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Directions to “ CHRISTOPHER WRAY EDWARDSON MD” Practice Location

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