Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD60891432 | WA |
N | 111NI0900X | Internist | MD60891432 | WA |
Y | 207RH0000X | Hematologist | MD60891432 | WA |
N | 207RX0202X | Medical Oncology | MD60891432 | WA |
NPI | 1124469093 |
---|---|
Provider Name | Dr. Chanudi Weerasinghe |
First Address | Vancouver, WA 98683-8004 |
Second Address | Staten Island, NY 10305-3436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2013 |
Last Update Date | 30/07/2019 |