NPI 1407908650

Raisa Premysler, MD

Practitioner General Practice Physician Portland, OR

Practice location

Address: 426 SW Stark St 8th Floor, Portland, OR 97204-2347
Phone: (503) 988-3674
Fax: (503) 988-6905
Mailing address: 421 SW Oak St 210, Portland, OR 97204-1817

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence MD15738 (OR)

Other General Practice providers in Oregon →

Registry record

NPI: 1407908650
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Jan 2007
Record last updated: 18 Dec 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.