Individual
JAISHANKER NAUTIYAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3620 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 280-2931
(503) 280-2938
Mailing address
3620 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 280-2931
(503) 280-2938
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD22367
OR
2085R0203X
Therapeutic Radiology Physician
MD22367
OR
Other
Enumeration date
10/06/2005
Last updated
02/04/2022
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