Provider Demographics
NPI:1780699256
Name:MULARSKI, RICHARD ANTHONY (MD, MCR, MSHS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANTHONY
Last Name:MULARSKI
Suffix:
Gender:M
Credentials:MD, MCR, MSHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10180 SE SUNNYSIDE RD
Mailing Address - Street 2:PULMONARY - SMC
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-8970
Mailing Address - Country:US
Mailing Address - Phone:503-571-2727
Mailing Address - Fax:
Practice Address - Street 1:10180 SE SUNNYSIDE RD
Practice Address - Street 2:KAISER SUNNYSIDE MEDICAL CENTER - PULMONARY/CCM
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8970
Practice Address - Country:US
Practice Address - Phone:503-652-2880
Practice Address - Fax:503-335-6311
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20566207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR286839Medicaid
OR286839Medicaid
H08708Medicare UPIN