Individual
SHADAB NASREEN AIJAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5220 NE 122ND AVENUE, PORTLAND, OR 97230
(503) 306-1023
Mailing address
5220 NE 122ND AVENUE, PORTLAND, OR 97230
(503) 306-1023
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
C130153
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
M-10339
ID
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD00032166
WA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD17423
OR
Other
Enumeration date
06/30/2017
Last updated
06/30/2017
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