Provider Demographics
NPI:1689008682
Name:SHENOY, ANUSHKA (MD)
Entity Type:Individual
Prefix:
First Name:ANUSHKA
Middle Name:
Last Name:SHENOY
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 1:811 E BURNSIDE ST STE 217
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1231
Mailing Address - Country:US
Mailing Address - Phone:503-476-1189
Mailing Address - Fax:
Practice Address - Street 1:15455 NW GREENBRIER PKWY
Practice Address - Street 2:SUITE #120
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-9700
Practice Address - Country:US
Practice Address - Phone:503-476-1189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1936762084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry