Healthcare Provider Details
I. General information
NPI: 1043285711
Provider Name (Legal Business Name): AMIT SADANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/17/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10180 SE SUNNYSIDE RD
CLACKAMAS OR
97015-8970
US
IV. Provider business mailing address
500 NE MULTNOMAH ST STE 100
PORTLAND OR
97232-2031
US
V. Phone/Fax
- Phone: 503-652-2880
- Fax:
- Phone: 800-813-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | MD27999 |
| License Number State | OR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: