Raymond E Brady III, MD
Individual provider Active NPI Allergy & Immunology Physician · Astoria, OR
NPI 1912975574 · NPPES record last updated May 7, 2009
Key facts
- NPI
- 1912975574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Allergy & Immunology Physician 207K00000X
- License
- MD00017613 (WA)
- Practice address
- 2055 Exchange St.
Suite 150
Astoria, OR 97103 - Phone
- (503) 325-7546
- Fax
- (503) 325-7343
- NPI assigned
- Mar 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00017613 | WA | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Know Allergy LLC | Past |
Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | MD00017613 | WA | Yes |
| Allergy & Immunology Physician | 207K00000X | MD10611 | OR |
Addresses
Primary practice location
2055 Exchange St.
Suite 150
Astoria, OR 97103
Mailing address
2055 Exchange St.
Suite 150
Astoria, OR 97103
Phone (503) 325-7546
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD00017613 | Other | WA | WASHINGTON LICENSE |
| MD10611 | Other | OR | OREGON LICENSE |
Other providers in Astoria, OR
- Patricia Ann Boullie
- Judy Elaine Bouton
- Nicholas Bowling
- Barbara Ann Bradley
- Brady Medical Consultants, PLLC
- Leah Danielle Bridges
- Tracie Brockey
- Aaron Andrew Brown
- Keri Kay Brown
- Gabriella Z Bruce
All providers in Astoria, OR · Allergy & Immunology Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.