Provider Demographics
NPI:1083851190
Name:PERRY, RAYMOND F (ORT/L)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:F
Last Name:PERRY
Suffix:
Gender:M
Credentials:ORT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 W SHORE RD
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-9013
Mailing Address - Country:US
Mailing Address - Phone:360-661-5468
Mailing Address - Fax:360-679-6646
Practice Address - Street 1:950 SE REGATTA DR # 101
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-5451
Practice Address - Country:US
Practice Address - Phone:360-679-1039
Practice Address - Fax:360-679-6646
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00002538225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist