Provider Demographics
NPI:1639200348
Name:TURNER, RAY MELVIN
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:MELVIN
Last Name:TURNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 SE 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5229
Mailing Address - Country:US
Mailing Address - Phone:503-754-1688
Mailing Address - Fax:
Practice Address - Street 1:9111 NE SUNDERLAND RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-1708
Practice Address - Country:US
Practice Address - Phone:503-280-6646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)