Provider Demographics
NPI:1053501742
Name:SHAH, RASHMI CHANDEKAR (MD)
Entity Type:Individual
Prefix:
First Name:RASHMI
Middle Name:CHANDEKAR
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RASHMI
Other - Middle Name:VIDYADHAR
Other - Last Name:CHANDEKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9555 SW BARNES RD STE 150
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6691
Mailing Address - Country:US
Mailing Address - Phone:503-297-3384
Mailing Address - Fax:503-297-0863
Practice Address - Street 1:9555 SW BARNES RD STE 150
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6691
Practice Address - Country:US
Practice Address - Phone:503-297-3384
Practice Address - Fax:503-297-0863
Is Sole Proprietor?:No
Enumeration Date:2007-07-28
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246757207R00000X, 207RG0300X
MI4301088351207R00000X
ORMD167809207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000WCPHROtherMEDICARE PROVIDER NUMBER