Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101246757 | VA |
N | 111NI0900X | Internist | 0101246757 | VA |
N | 207R00000X | Internist | 4301088351 | MI |
N | 111NI0900X | Internist | 4301088351 | MI |
N | 207RG0300X | Geriatric Medicine | 0101246757 | VA |
Y | 207RR0500X | Rheumatology | MD167809 | OR |
NPI | 1053501742 |
---|---|
Provider Name | Rashmi Chandekar Shah |
First Address | Portland, OR 97225-6691 |
Second Address | Portland, OR 97225-6691 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2007 |
Last Update Date | 10/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R0000WCPHR | MEDICARE PROVIDER NUMBER (01) | OR |