Individual
AMISH J DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 N GRAHAM ST., SUITE 200, PORTLAND, OR 97227
(503) 413-7162
(503) 413-4711
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD00045340
WA
207RI0011X
Interventional Cardiology Physician
MD00045340
WA
207RI0011X
Interventional Cardiology Physician
Primary
MD169913
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199511
LABOR AND INDUSTRIES
WA
05
—
1134282932
—
WA
05
—
500683050
—
OR
05
—
8431264
—
WA
Enumeration date
12/19/2006
Last updated
02/01/2017
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