Basic Information
| Provider Information | |||||||||
| NPI: | 1073518551 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TIEN | ||||||||
| FirstName: | RAYMOND | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 NE NETT RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413823344 | ||||||||
| FaxNumber: | 5413821681 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 NE NETT RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413823344 | ||||||||
| FaxNumber: | 5413821681 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2005 | ||||||||
| LastUpdateDate: | 05/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MD24627 | OR | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.