Provider Demographics
NPI:1255439725
Name:RAWCLIFFE, LYNN WILLIAM (DPM)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:WILLIAM
Last Name:RAWCLIFFE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 HWY 99 N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-8900
Mailing Address - Country:US
Mailing Address - Phone:541-482-4926
Mailing Address - Fax:541-488-1732
Practice Address - Street 1:1661 HWY 99 N
Practice Address - Street 2:SUITE 201
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-8900
Practice Address - Country:US
Practice Address - Phone:541-482-4926
Practice Address - Fax:541-488-1732
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP00358213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR023677004OtherREGENCE BLUE CROSS
1297890001OtherREGION D DMERCCCIGNA MC
OR234449Medicaid
OR234449Medicaid
V00755Medicare UPIN