Provider Demographics
NPI:1962450551
Name:RAMOS, MAYDA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MAYDA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MD
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 278
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071-0278
Mailing Address - Country:US
Mailing Address - Phone:971-983-5260
Mailing Address - Fax:
Practice Address - Street 1:690 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT ANGEL
Practice Address - State:OR
Practice Address - Zip Code:97362-9518
Practice Address - Country:US
Practice Address - Phone:503-845-2000
Practice Address - Fax:503-845-2384
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18575207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR121041Medicaid
F69361Medicare UPIN
OR121041Medicaid