Individual
KALPANA PRABUDDHIKA KATUDENIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2005 W MAIN ST STE 110, BATTLE GROUND, WA 98604-4311
(360) 882-2778
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP61037628
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2161360
—
WA
Enumeration date
04/26/2015
Last updated
08/13/2020
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