Provider Demographics
NPI:1447293162
Name:DOGRA, VIVEK (MD)
Entity type:Individual
Prefix:
First Name:VIVEK
Middle Name:
Last Name:DOGRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9450 SW BARNES ROAD
Mailing Address - Street 2:# 140
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225
Mailing Address - Country:US
Mailing Address - Phone:503-688-5536
Mailing Address - Fax:503-688-5509
Practice Address - Street 1:9450 SW BARNES ROAD
Practice Address - Street 2:# 140
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225
Practice Address - Country:US
Practice Address - Phone:503-688-5536
Practice Address - Fax:503-688-5509
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23070207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORH74305Medicare UPIN
OR1447293162Medicare UPIN