Provider Demographics
NPI:1477657617
Name:MARTIN, RICHARD JAMES (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1210
Mailing Address - Country:US
Mailing Address - Phone:541-386-2300
Mailing Address - Fax:541-436-4113
Practice Address - Street 1:810 13TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1210
Practice Address - Country:US
Practice Address - Phone:541-386-2300
Practice Address - Fax:541-436-4113
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO27031208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
BM7713933OtherDEA
H75186Medicare UPIN