Provider Demographics
NPI:1336807221
Name:CHITALE, ANUJA SHARADCHANDRA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:ANUJA
Middle Name:SHARADCHANDRA
Last Name:CHITALE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 SE QUAIL POINTE CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-6137
Mailing Address - Country:US
Mailing Address - Phone:806-407-0441
Mailing Address - Fax:
Practice Address - Street 1:5262 NE BROOKWOOD PKWY
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5345
Practice Address - Country:US
Practice Address - Phone:503-395-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63959208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation