Raisa Premysler, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD15738 Issued in OR

Practice address

426 SW Stark St
8TH Floor
Portland, OR 97204-2347

Phone

(503) 988-3674

Fax

(503) 988-6905

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1407908650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SW OAK ST",
            "address_2": "210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041817",
            "telephone_number": "503-988-3674",
            "fax_number": "503-988-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 SW STARK ST",
            "address_2": "8TH FLOOR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042347",
            "telephone_number": "503-988-3674",
            "fax_number": "503-988-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREMYSLER",
        "first_name": "RAISA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "MD15738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Oregon Medical P C
• Premise Health of Oregon Medical P C
• Premise Health of Oregon Medical PC
• Janice C. Premo
• Valerie A Premore, MBA, PMP, CCRP
• Thomas Joseph Prendergast, M.D.
• William John Prendergast III, MD
• Elaine Prendiville, MEDICAL STUDENT
• Susan M Preneta
• Kathy Naylor Prenevost, MSW

• General Practice Physician in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.