Provider Demographics
NPI:1578663100
Name:GOEL, ANITA A (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:A
Last Name:GOEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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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:2006-09-24
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23088207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287450Medicaid
ORG59828Medicare UPIN
OR109873Medicare ID - Type Unspecified