Provider Demographics
NPI:1730467861
Name:ARREGUIN, RAYMOND JOSEPH (DPT)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:ARREGUIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16083 SW UPPER BOONES FERRY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7736
Mailing Address - Country:US
Mailing Address - Phone:800-219-8835
Mailing Address - Fax:503-639-9699
Practice Address - Street 1:837 SW FIRST AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-3307
Practice Address - Country:US
Practice Address - Phone:503-450-0591
Practice Address - Fax:503-450-0867
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06621225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500637516Medicaid
ORR160875Medicare PIN
ORR160874Medicare PIN
ORR187800Medicare PIN