Provider Demographics
NPI:1295841450
Name:RAINKA, S. RAYMOND (DMD)
Entity Type:Individual
Prefix:DR
First Name:S.
Middle Name:RAYMOND
Last Name:RAINKA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18676 WILLAMETTE DR STE 302
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-1718
Mailing Address - Country:US
Mailing Address - Phone:503-635-3948
Mailing Address - Fax:503-635-1265
Practice Address - Street 1:18676 WILLAMETTE DR STE 302
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-1718
Practice Address - Country:US
Practice Address - Phone:503-635-3948
Practice Address - Fax:503-635-1265
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD67621223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics