Jetmalani, Shobha N.

Jetmalani, Shobha N. is an individual health care provider with primary practice located at 18040 Sw Lower Boones Ferry Rd Suite 100, Tigard OR 97224-7258. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Jetmalani, Shobha N. can be contacted via phone (503) 215-0700.

Contact Information

Primary practice address
18040 Sw Lower Boones Ferry Rd Suite 100 Tigard OR 97224-7258
Phone: (503) 215-0700
Fax: (503) 216-0750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD15615 Oregon

Profile Details

NPI number 1407822687
LBN Legal business name Jetmalani, Shobha N.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Oct 11th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407822687 NPPES
Oregon MEDICAID 031216
Oregon Other P00818469

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