Provider Demographics
NPI:1548084312
Name:RICHA UPPAL MD LLC
Entity type:Organization
Organization Name:RICHA UPPAL MD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHA
Authorized Official - Middle Name:
Authorized Official - Last Name:UPPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:971-229-4545
Mailing Address - Street 1:1849 NW KEARNEY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1453
Mailing Address - Country:US
Mailing Address - Phone:971-229-4545
Mailing Address - Fax:503-966-2427
Practice Address - Street 1:1849 NW KEARNEY ST STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1453
Practice Address - Country:US
Practice Address - Phone:971-229-4545
Practice Address - Fax:503-966-2427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care