Provider Demographics
NPI:1528089026
Name:PATEL, SONEL P (MD)
Entity type:Individual
Prefix:MRS
First Name:SONEL
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
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:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4400 NE HALSEY ST
Practice Address - Street 2:BUILDING 2
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1545
Practice Address - Country:US
Practice Address - Phone:503-539-9996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR241587Medicaid
NY00335915Medicaid
ORP00830958OtherRR MEDICARE- PHS
ORR153510Medicare PIN
ORR157538Medicare PIN
ORR153507Medicare PIN
ORR174627Medicare PIN
ORR153506Medicare PIN
ORR153509Medicare PIN
ORR158967Medicare PIN
ORR139866Medicare PIN
NY00335915Medicaid
ORR163848Medicare PIN
ORR177413Medicare PIN
ORP00830958OtherRR MEDICARE- PHS
OR241587Medicaid