Provider Demographics
NPI:1740943869
Name:THE VASECTOMY CLINIC, P.C.
Entity type:Organization
Organization Name:THE VASECTOMY CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHRIKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJITHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-219-1201
Mailing Address - Street 1:12511 SW 68TH AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8298
Mailing Address - Country:US
Mailing Address - Phone:800-636-4090
Mailing Address - Fax:206-985-2875
Practice Address - Street 1:12511 SW 68TH AVE STE 150
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-8298
Practice Address - Country:US
Practice Address - Phone:800-636-4090
Practice Address - Fax:206-985-2875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty