Provider Demographics
NPI:1548365521
Name:SLOOP, RAYMOND RICHARD (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:RICHARD
Last Name:SLOOP
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 1:307 A 12TH AVE
Mailing Address - Street 2:#16
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902
Mailing Address - Country:US
Mailing Address - Phone:509-452-1234
Mailing Address - Fax:509-249-5831
Practice Address - Street 1:307 A 12TH AVE
Practice Address - Street 2:#16
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:509-452-1234
Practice Address - Fax:509-249-5831
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000291572084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA10779OtherGROUP HEALTH
WA130017660OtherRAILROAD MEDICARE
WA1100643Medicaid
WA113576OtherL & I