Provider Demographics
NPI:1417108036
Name:ROBERT W RAMSEY DC PC
Entity Type:Organization
Organization Name:ROBERT W RAMSEY DC PC
Other - Org Name:GRESHAM TOWN FAIR CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-667-6744
Mailing Address - Street 1:592 NW EASTMAN PKWY
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-7253
Mailing Address - Country:US
Mailing Address - Phone:503-667-6744
Mailing Address - Fax:503-661-7896
Practice Address - Street 1:592 NW EASTMAN PKWY
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7253
Practice Address - Country:US
Practice Address - Phone:503-667-6744
Practice Address - Fax:503-661-7896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR106206Medicare Oscar/Certification
ORU78694Medicare UPIN