Provider Demographics
NPI:1508809781
Name:DOSHI, HEENA SATISH (MD)
Entity Type:Individual
Prefix:MS
First Name:HEENA
Middle Name:SATISH
Last Name:DOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:503-215-6494
Mailing Address - Fax:
Practice Address - Street 1:12400 NW CORNELL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5616
Practice Address - Country:US
Practice Address - Phone:503-626-0939
Practice Address - Fax:503-626-6161
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18415207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR057948Medicaid
DOWCQKWDMedicare ID - Type Unspecified
OR057948Medicaid