Provider Demographics
NPI:1689688137
Name:KRAJBICH, JOSEPH IVAN (MD FRCSC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:IVAN
Last Name:KRAJBICH
Suffix:
Gender:M
Credentials:MD FRCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500, LOCKBOX 7642
Mailing Address - Street 2:SHRINERS HOSPITAL FOR CHILDREN PORTLAND
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-7642
Mailing Address - Country:US
Mailing Address - Phone:813-281-8115
Mailing Address - Fax:813-281-8656
Practice Address - Street 1:3101 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3009
Practice Address - Country:US
Practice Address - Phone:503-221-3424
Practice Address - Fax:503-221-3490
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD18323207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR06038Medicaid
OR06038Medicaid