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Individual

SASHI K PEDAPATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10150 SE 32ND AVE, MILWAUKIE, OR 97222-6516
(503) 513-8336
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD156698
OR
207R00000X
Internal Medicine Physician
MD60023056
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0256047
WASHINGTON DOL
WA
05
500641783
OR
05
8545014
WA
Enumeration date
05/23/2007
Last updated
03/12/2012
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