Individual
DR. SUPRIYA KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1547 NE 40TH AVE STE B, PORTLAND, OR 97232-1862
(503) 284-1937
(503) 284-3908
Mailing address
1840 E RAY RD, CHANDLER, AZ 85225-8720
(855) 397-0197
(800) 272-6512
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
54992
KY
207RN0300X
Nephrology Physician
Primary
MD 28660
OR
207RN0300X
Nephrology Physician
MD60054413
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1090617
—
WA
05
—
276227
—
OR
Enumeration date
10/19/2006
Last updated
11/22/2024
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