Individual
SANJAY KRISHNASWAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7764
Mailing address
408 NW 12TH AVE APT 302, PORTLAND, OR 97209-2945
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
MD26233
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276328
—
OR
Enumeration date
07/31/2006
Last updated
07/08/2007
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