Individual
DR. AJAY WANCHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10101 SE MAIN ST STE 2011, PORTLAND, OR 97216-2457
(503) 261-6912
(503) 251-6357
Mailing address
10101 SE MAIN ST STE 2011, PORTLAND, OR 97216-2457
(503) 261-6912
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD160711
OR
Other
Enumeration date
06/17/2009
Last updated
03/17/2018
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