Healthcare Provider Details

I. General information

NPI: 1205332525
Provider Name (Legal Business Name): SAI SHALINI PILLARISETTY M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date: 11/16/2018
Reactivation Date: 12/07/2018

III. Provider practice location address

505 NE 87TH AVE STE 350
VANCOUVER WA
98664-1965
US

IV. Provider business mailing address

2601 OCEAN PARKWAY
BROOKLYN NY
11235
US

V. Phone/Fax

Practice location:
  • Phone: 360-514-2550
  • Fax: 360-514-1927
Mailing address:
  • Phone: 718-616-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD61608192
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: