Individual
SOUNAK N MISRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 N HAYDEN ISLAND DR STE 100, PORTLAND, OR 97217-8130
(971) 533-5840
(971) 270-2806
Mailing address
2530 SE 26TH AVE APT 407, PORTLAND, OR 97202-1484
(913) 636-9616
(971) 270-2806
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD26161
OR
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
MD26161
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD26161
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271033
—
OR
01
—
P00294103
RR MEDICARE
OR
Enumeration date
05/24/2006
Last updated
01/07/2019
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