Provider Demographics
NPI:1013334556
Name:UPALA, SIKARIN (MD)
Entity Type:Individual
Prefix:MR
First Name:SIKARIN
Middle Name:
Last Name:UPALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2367
Mailing Address - Country:US
Mailing Address - Phone:360-414-7656
Mailing Address - Fax:
Practice Address - Street 1:ASTRIA HEALTH CENTER
Practice Address - Street 2:1420 AHTANUM RIDGE DR.
Practice Address - City:UNION GAP
Practice Address - State:WA
Practice Address - Zip Code:98903-9183
Practice Address - Country:US
Practice Address - Phone:509-454-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-22
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036142546207RE0101X
WAMD613127232083B0002X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine