Provider Demographics
NPI:1306371893
Name:PIPALIA, AMRISH TULSI (MD)
Entity Type:Individual
Prefix:
First Name:AMRISH
Middle Name:TULSI
Last Name:PIPALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AMRISH
Other - Middle Name:TULSIBHAI
Other - Last Name:PIPALIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:GRADUATE MEDICAL EDUCATION
Mailing Address - Street 2:MAIL CODE: L579
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3098
Mailing Address - Country:US
Mailing Address - Phone:503-494-8652
Mailing Address - Fax:503-494-8513
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-22
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD2095052084P0800X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program