RAYMOND A WALLER (NPI# 1922176528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922176528 |
| Entity Type | Individual |
| Full Name | RAYMOND A WALLER |
| Credential | DDS |
| Practice Address |
1303 16th Ave Clarkston WA 99403-2956 |
| Practice Telephone | 5097587150 |
| Practice Fax Number | 5097588346 |
| Mailing Telephone | 5097587150 |
| Mailing Fax Number | 5097588346 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DE00007388 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 5020086 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225536840 | Raymond Taylor Waller IIi | Marriage & Family Therapist | 2101 N Glenoaks Blvd, Burbank, CA 91504-2828 | 2018-01-29 |
| 1689818882 | Raymond Waller | Counselor | 91 Glendale St, Highland Park, MI 48203-3274 | 2009-05-01 |
| Street Address |
1303 16TH AVE |
| City | CLARKSTON |
| State | WA |
| Zip Code | 99403-2956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306409669 | Jessica Elaine Krull | Specialist/Technologist | 807 3rd Street, Clarkston, WA 99403 | 2019-04-22 |
| 1477006526 | Idaho County Rideshare | Non-emergency Medical Transport (VAN) | 1470 Elm Street, Clarkston, WA 99403 | 2016-07-25 |
| 1679921340 | Jonathan Preszler | Counselor | 629 6th Street, Educational and Psychological Services, Clarkston, WA 99403 | 2016-06-02 |
| 1104204957 | Optimal Health and Wellness | Clinic/Center | 1267 Belmont Way, Clarkston, WA 99403 | 2015-05-13 |
| 1326456351 | David Nygren | Pharmacist | 506 5th St, Clarkston, WA 99403 | 2014-07-22 |
| 1255672895 | Alpowa Healthcare, Inc. | Hospice Care, Community Based | 1370 Bridge Street, Clarkston, WA 99403 | 2013-03-06 |
| 1265799407 | Elizabeth Bagnulo Dacey | Pathology | 1225 Highland Avenue, Clarkston, WA 99403 | 2012-04-12 |
| 1649586256 | Zeeshan Afzal | Internal Medicine | 1119 Highland Ave Ste 3, Clarkston, WA 99403 | 2010-08-20 |
| 1154657955 | Twin River Vision, Inc. | Optometrist | 306 5th Street, Clarkston, WA 99403 | 2009-10-29 |
| 1649429317 | Elizabeth Marie Allen-racicot | Specialist | 1013 Bridge Street, Clarkston, WA 99403 | 2008-09-17 |
| Find all providers in zip 99403 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164950440 | Matthew Bryson Thomas | Dentist | 6080 Dixie Hwy Ste A, Clarkston, MI 48346-3493 | 2017-05-31 |
| 1366758633 | Thomas Joseph Rydzon | Dentist | 7024 Scenic Rdg, Clarkston, MI 48346-1345 | 2010-08-25 |
| 1790956530 | Thu D. Vu | Dentist | 3596 Hill Street, Clarkston, GA 30021 | 2008-03-20 |
| 1790953818 | Janet Binkowski | Dentist | 6100 Dixie Hwy Ste A, Clarkston, MI 48346-3496 | 2008-02-11 |
| 1548481849 | Brian Paul Davidson | Dentist | 5720 Clarkston Rd, Clarkston, MI 48348-3715 | 2007-05-02 |
| 1780740712 | Scott W Joslin | Dentist | 844 6th St, Clarkston, WA 99403-2013 | 2006-12-27 |
| 1366500118 | Clarkston Oaks Family Dentistry | Dentist | 6100 Dixie Hwy, #a, Clarkston, MI 48346-3496 | 2006-12-05 |
| 1700958006 | Robert Marc Kleiner | Dentist | 4122 E Ponce De Leon Ave, Suite #5, Clarkston, GA 30021-1838 | 2006-11-14 |
| 1548339575 | Best Care Dental Inc. | Dentist | 3700 Market St Ste A2, Clarkston, GA 30021-2652 | 2006-11-06 |
| 1740375674 | Noelle Rene Gailey | Dentist | 7650 Dixie Hwy Ste 120, Clarkston, MI 48346 | 2006-10-04 |
| Find all providers in CLARKSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.