Provider Demographics
NPI:1548265457
Name:JHOOTY, RAMNIK S (MD)
Entity type:Individual
Prefix:DR
First Name:RAMNIK
Middle Name:S
Last Name:JHOOTY
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:PO BOX 3777
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3777
Mailing Address - Country:US
Mailing Address - Phone:503-413-3900
Mailing Address - Fax:503-413-3710
Practice Address - Street 1:501 N GRAHAM ST., SUITE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227
Practice Address - Country:US
Practice Address - Phone:503-413-7162
Practice Address - Fax:503-413-4711
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24167174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR286221Medicaid
OR804330012OtherBLUE CROSS BLUE SHIELD
OR115128Medicare ID - Type Unspecified
OR286221Medicaid
OR804330012OtherBLUE CROSS BLUE SHIELD
ORR177743Medicare PIN