Provider Demographics
NPI:1740484518
Name:LAURA A STARRETT MD & RICHARD P STARRETT MD
Entity type:Organization
Organization Name:LAURA A STARRETT MD & RICHARD P STARRETT MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:STARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-386-0007
Mailing Address - Street 1:1021 JUNE ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1516
Mailing Address - Country:US
Mailing Address - Phone:541-386-0007
Mailing Address - Fax:541-386-2675
Practice Address - Street 1:1021 JUNE ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1516
Practice Address - Country:US
Practice Address - Phone:541-386-0007
Practice Address - Fax:541-386-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
R137910Medicare PIN