Provider Demographics
NPI:1760456925
Name:USHER, CRAIGAN TODD (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIGAN
Middle Name:TODD
Last Name:USHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:930 NW 12TH AVE
Mailing Address - Street 2:#328
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3066
Mailing Address - Country:US
Mailing Address - Phone:503-360-4771
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:MAIL CODE DC7P
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-418-5775
Practice Address - Fax:503-418-5774
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD283652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry