Basic Information
| Provider Information | |||||||||
| NPI: | 1306371893 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIPALIA | ||||||||
| FirstName: | AMRISH | ||||||||
| MiddleName: | TULSI | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PIPALIA | ||||||||
| OtherFirstName: | AMRISH | ||||||||
| OtherMiddleName: | TULSIBHAI | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | GRADUATE MEDICAL EDUCATION | ||||||||
| Address2: | MAIL CODE: L579 | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972393098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034948652 | ||||||||
| FaxNumber: | 5034948513 | ||||||||
| Practice Location | |||||||||
| Address1: | 3710 SW US VETERANS HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972392964 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032208262 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2017 | ||||||||
| LastUpdateDate: | 08/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD209505 | OR | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | MD209505 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.