Individual
DR. DEEPIKA WALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2610 UHRMANN RD, KLAMATH FALLS, OR 97601-1123
(541) 274-4171
Mailing address
PO BOX 2120, PORTLAND, OR 97208-2120
(541) 274-6556
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
A49021
CA
207RX0202X
Medical Oncology Physician
Primary
CP203502
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A490210
BCBS
CA
01
—
BU558W
MCARE PTAN
CA
Enumeration date
12/13/2005
Last updated
12/22/2021
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