| Doctor Name: | DR. RAISA PREMYSLER |
| NPI Number: | 1407908650 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | MD15738 |
| Business Practice Address: | 426 Sw Stark St 8th Floor Portland, OR - 972042347 |
| Business Phone Number: | 5039883674 |
| Business Fax Number: | 5039886905 |
| Mailing Address: | 421 Sw Oak St, 210 PORTLAND |
| State: | OR |
| Postal Code: | 972041817 |
| Phone Number: | 5039883674 |
| Fax Number: | 5039886905 |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 12/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD15738 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |