Provider Demographics
NPI:1538973490
Name:SUBRAMANIAM, SUJITHA
Entity type:Individual
Prefix:
First Name:SUJITHA
Middle Name:
Last Name:SUBRAMANIAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21181 SW BALER WAY
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9456
Mailing Address - Country:US
Mailing Address - Phone:971-331-9516
Mailing Address - Fax:
Practice Address - Street 1:21181 SW BALER WAY
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9456
Practice Address - Country:US
Practice Address - Phone:971-331-9516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter