Provider Demographics
NPI:1023077500
Name:KARMY-JONES, RIYAD CARADOG (MD)
Entity type:Individual
Prefix:MR
First Name:RIYAD
Middle Name:CARADOG
Last Name:KARMY-JONES
Suffix:
Gender:M
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 8945
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98668-8945
Mailing Address - Country:US
Mailing Address - Phone:360-514-1854
Mailing Address - Fax:360-514-6063
Practice Address - Street 1:300 N GRAHAM ST STE 125
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1683
Practice Address - Country:US
Practice Address - Phone:503-413-3714
Practice Address - Fax:503-413-2061
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035499208600000X, 2086S0102X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8218794Medicaid
G21321Medicare UPIN
WA8218794Medicaid