Individual
DR. RENGANATHAN SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4300
(503) 494-4323
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4300
(503) 494-4323
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
MD00047649
WA
207K00000X
Allergy & Immunology Physician
Primary
MD29268
OR
207R00000X
Internal Medicine Physician
MD29268
OR
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
MD00047649
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8481277
—
WA
Enumeration date
09/16/2006
Last updated
12/23/2024
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