Provider Demographics
NPI:1083855175
Name:GERALD B RICH, MD, PC
Entity Type:Organization
Organization Name:GERALD B RICH, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RADHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREADEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-228-4414
Mailing Address - Street 1:11790 SW BARNES RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5934
Mailing Address - Country:US
Mailing Address - Phone:503-228-4414
Mailing Address - Fax:503-228-7293
Practice Address - Street 1:11790 SW BARNES RD
Practice Address - Street 2:SUITE 330
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5934
Practice Address - Country:US
Practice Address - Phone:503-228-4414
Practice Address - Fax:503-228-7293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-19
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty