Organization
OREGON PEDIATRICS NE PORTLAND PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUPA KIRIT SHAH MD (CO OWNER & MEDICAL DIRECTOR)
(503) 659-1694
Entity
Organization
Contact information
Practice address
5050 NE HOYT ST, STE B55, PORTLAND, OR 97213-2957
(503) 233-5393
(503) 659-8984
Mailing address
5050 NE HOYT ST, STE B55, PORTLAND, OR 97213-2957
(503) 233-5393
(503) 659-8984
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287523
—
OR
Enumeration date
06/21/2006
Last updated
11/28/2011
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