Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | D10370 | OR |
Y | 204E00000X | Oral & Maxillofacial Surgeon | MD161538 | OR |
NPI | 1043415870 |
---|---|
Provider Name | Dr. Ashish A Patel |
First Address | Portland, OR 97209-1453 |
Second Address | Portland, OR 97209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 02/10/2020 |