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Individual

SUMATHI DEVARAJAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3930 SE DIVISION ST, PORTLAND, OR 97202-1643
(503) 418-3900
Mailing address
3930 SE DIVISION ST, PORTLAND, OR 97202-1643
(503) 418-3900

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD23066
OR
207QG0300X
Geriatric Medicine (Family Medicine) Physician
MD23066
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
181881
OR
Enumeration date
11/08/2006
Last updated
07/16/2007
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