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General NPI Number Information
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NPI Number | 1831530799
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Entity Type | Individual
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Provider Name | NATTAMOL HOSIRILUCK M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2013
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 7360 W DESCHUTES AVE
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City | KENNEWICK
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State | WA
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Zip | 99336
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Country | US
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Telephone | 509-783-0144
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Fax | 509-783-8244
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Provider Business Mailing Address
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Address Line | 9495 SW LOCUST ST STE G
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City | PORTLAND
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State | OR
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Zip | 97223-6683
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Country | US
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Telephone | 971-314-4522
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Fax | 971-314-4527
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD60903398
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD211251
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License Number State | OR
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