Provider Demographics
NPI:1700812898
Name:STAPLETON, JOSEPH PAUL (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PAUL
Last Name:STAPLETON
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 1:9300 SE 91ST AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97086-3749
Mailing Address - Country:US
Mailing Address - Phone:503-775-6500
Mailing Address - Fax:503-775-2275
Practice Address - Street 1:9300 SE 91ST AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97086-3749
Practice Address - Country:US
Practice Address - Phone:503-775-6500
Practice Address - Fax:503-775-2275
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13551207LP2900X
ORMD13551207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR050004482OtherRR MEDICARE
WA1001692Medicaid
OR118463Medicaid
OR00WCJPPJ1Medicare PIN
OR118463Medicaid