Provider Demographics
NPI:1770683864
Name:RISHEL, RAYMOND MARION (RN)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:MARION
Last Name:RISHEL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:883 SHORES ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3090
Mailing Address - Country:US
Mailing Address - Phone:503-315-9862
Mailing Address - Fax:503-315-9862
Practice Address - Street 1:883 SHORES ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3090
Practice Address - Country:US
Practice Address - Phone:503-315-9862
Practice Address - Fax:503-315-9862
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR098023Medicaid