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General NPI Number Information
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NPI Number | 1700058328
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Entity Type | Individual
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Provider Name | RADHIKA PURUSHOTHAMAN MD,MPH
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Gender | Female
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 501 N GRAHAM ST STE 375
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City | PORTLAND
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State | OR
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Zip | 97227-2001
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Country | US
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Telephone | 503-413-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 3285 NW BAUER WOODS DR
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City | PORTLAND
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State | OR
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Zip | 97229-7022
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Country | US
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Telephone | 610-864-9597
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | A115271
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License Number State | CA
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