Provider Demographics
NPI:1760574230
Name:CLOUTIER, ROBERT LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LOUIS
Last Name:CLOUTIER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3181 SAM JACKSON PARK RD
Mailing Address - Street 2:OHSU DEPARTMENT OF EMERGENCY MEDICINE
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3098
Mailing Address - Country:US
Mailing Address - Phone:503-494-2647
Mailing Address - Fax:503-494-4997
Practice Address - Street 1:3181 SAM JACKSON PARK RD
Practice Address - Street 2:OHSU DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3098
Practice Address - Country:US
Practice Address - Phone:503-494-2647
Practice Address - Fax:503-494-4997
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
ORMD22962207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR109539Medicare ID - Type Unspecified
ORG63952Medicare UPIN