Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DO1408 | NV |
Y | 207Q00000X | Family Doctor | DO203436 | OR |
N | 207QA0401X | Family Doctor - Addiction Medicine | DO1408 | NV |
NPI | 1104843911 |
---|---|
Provider Name | Nalini Velayudhan |
First Address | Portland, OR 97210-5103 |
Second Address | Tualatin, OR 97062-7707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 29/04/2021 |