Provider Demographics
NPI:1518996198
Name:RAGADE, NAMRATA (MD)
Entity Type:Individual
Prefix:
First Name:NAMRATA
Middle Name:
Last Name:RAGADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12670 NW BARNES RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-9001
Mailing Address - Country:US
Mailing Address - Phone:503-648-9565
Mailing Address - Fax:503-648-1282
Practice Address - Street 1:12670 NW BARNES RD STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-9001
Practice Address - Country:US
Practice Address - Phone:503-648-9565
Practice Address - Fax:503-648-1282
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27823207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205820301Medicaid
MO205820301Medicaid
MO002013590Medicare ID - Type Unspecified