Provider Demographics
NPI:1528045853
Name:RAYMOND, JAMES F (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:RAYMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4525 3RD AVE SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1010
Mailing Address - Country:US
Mailing Address - Phone:360-412-8960
Mailing Address - Fax:360-412-8970
Practice Address - Street 1:4525 3RD AVE SE
Practice Address - Street 2:SUITE 100
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1010
Practice Address - Country:US
Practice Address - Phone:360-412-8960
Practice Address - Fax:360-412-8970
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD000328792085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8359846Medicaid
WAG49590Medicare UPIN
WAGAB37785Medicare ID - Type Unspecified