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General NPI Number Information
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NPI Number | 1881516573
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Entity Type | Organization
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Legal Business Name | PORTLAND PSYCHIATRY LLC
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 13215 SE MILL PLAIN BLVD STE C81101
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City | VANCOUVER
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State | WA
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Zip | 98684-6991
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Country | US
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Telephone | 253-385-3710
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Fax | 352-329-4293
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Provider Business Mailing Address
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Address Line | 12303 NE 107TH WAY
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City | VANCOUVER
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State | WA
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Zip | 98682-3145
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Country | US
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Telephone | 253-385-3710
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASKIRAT SINGH SIDHU
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Credential | MD
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Telephone | 253-385-3710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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