Organization
KIRIT S SHAH M.D., P.C.
Active
Other names
East Portland Urology Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BECKY JO BREWER M.A. (OFFICE MANAGER)
(503) 254-6418
Entity
Organization
Contact information
Practice address
171 NE 102ND AVE, PORTLAND, OR 97220-4169
(503) 254-6418
(503) 254-1029
Mailing address
171 NE 102ND AVE, PORTLAND, OR 97220-4169
(503) 254-6418
(503) 254-1029
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD12620
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226662
—
OR
Enumeration date
11/20/2012
Last updated
11/20/2012
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