MEDICARE: ANUJA MITTAL-HENKLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	MD25972	OR
2	207R00000X	Internal Medicine Physician	MD25972	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972518470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANUJA MITTAL-HENKLE MD

Provider Business Mailing Address
First Line	:	2875 NW STUCKI AVE
Second Line	:	KAISER WESTSIDE MEDICAL CENTER
City	:	HILLSBORO
State	:	OR
Zip	:	97124-5806
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2875 NW STUCKI AVE
Second Line	:	KAISER WESTSIDE MEDICAL CENTER
City	:	HILLSBORO
State	:	OR
Zip	:	97124-5806
Country	:	US
Telephone Number	:	503-571-4866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	02/20/2014

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