Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Raelin Fullmer I

Individual provider Internal Medicine Physician · NPI 1528487956

Raelin Fullmer I is an Internal Medicine in Tualatin, Oregon. Qualified in 2016, 10 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
10
Licensed in
OR
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

19300 SW 65th Ave
Tualatin, OR 97062
Phone: (503) 413-8407
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3600 Nw Samaritan Dr, Corvallis, OR 97330-3737 — (509) 993-6147
  • 3600 Nw Samaritan Dr, Corvallis, OR 97330-3737 — (509) 993-6147

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence DO193586 (OR)
Internal Medicine Physician Taxonomy 207R00000X · Licence 177948 (OR)

Record details

NPI number1528487956
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 14, 2014
Last updated in NPPESAugust 21, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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