Provider Demographics
NPI:1447259650
Name:JOE, MURRAY DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:DOUGLAS
Last Name:JOE
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 1:1508 DIVISION ST
Mailing Address - Street 2:STE. 115
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1582
Mailing Address - Country:US
Mailing Address - Phone:503-656-0601
Mailing Address - Fax:503-656-1389
Practice Address - Street 1:1508 DIVISION ST
Practice Address - Street 2:STE. 115
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1582
Practice Address - Country:US
Practice Address - Phone:503-656-0601
Practice Address - Fax:503-656-1389
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9660174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC92966Medicare UPIN
OR0000BHNXZMedicare ID - Type Unspecified