Provider Demographics
NPI:1255337572
Name:ZURASKY, JOHN F (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:ZURASKY
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 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:503-215-6494
Mailing Address - Fax:503-215-6644
Practice Address - Street 1:4805 NE GLISAN ST
Practice Address - Street 2:STE 3G37
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2933
Practice Address - Country:US
Practice Address - Phone:503-215-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1066422084N0400X
CAC1382322084N0400X
WAMD602168922084N0400X
ORMD1532372084N0400X, 2084A2900X
MT349012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00965906OtherRR MEDICARE - PHS
OR500630867Medicaid
ORR157757Medicare PIN
CACB269659Medicare PIN
H74400Medicare UPIN
ORR192514Medicare PIN
WAG896424Medicare PIN
AKK168130Medicare PIN
ORR192513Medicare PIN
WAG896243Medicare PIN
OR500630867Medicaid
WAG896425Medicare PIN
MTM011009486Medicare PIN