Individual
DEEPSHIKHA DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
610 NW 11TH ST, HERMISTON, OR 97838
(541) 667-3578
(541) 667-3580
Mailing address
PO BOX 1049, PENDLETON, OR 97850
(541) 966-1184
(541) 278-9365
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD23782
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028733
—
OR
Enumeration date
04/21/2006
Last updated
11/21/2007
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