Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | MD10821 | OR |
NPI | 1083640783 |
---|---|
Provider Name | Shakuntala Krishnamurthy |
First Address | Portland, OR 97281-3200 |
Second Address | Hillsboro, OR 97123-4246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 16/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
278754 | (05) | OR |
E05146 | (02) | OR |