Healthcare Provider Details

I. General information

NPI: 1780789958
Provider Name (Legal Business Name): SAIFUDDIN M KASUBHAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 N 5TH AVE
SEQUIM WA
98382-3045
US

IV. Provider business mailing address

PO BOX 850
PORT ANGELES WA
98362-0146
US

V. Phone/Fax

Practice location:
  • Phone: 360-683-9895
  • Fax: 360-582-5614
Mailing address:
  • Phone: 360-565-9237
  • Fax: 253-382-6301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD00040571
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD196540
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: