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Individual

DR. PRAKASH AMBADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9135 SW BARNES RD STE 461, PORTLAND, OR 97225-6643
(503) 216-1150
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD167591
OR

Other

Enumeration date
09/13/2011
Last updated
04/26/2022
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