Shasha, Khalil I.

Shasha, Khalil I. is an individual health care provider with primary practice located at 19300 Sw 65Th Ave , Tualatin OR 97062-7706. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Shasha, Khalil I. can be contacted via phone (503) 413-8407.

Contact Information

Primary practice address
19300 Sw 65Th Ave Tualatin OR 97062-7706
Phone: (503) 413-8407
Fax: (503) 413-6951
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD00041482 Washington
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X MD00041482 Washington
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD173729 Oregon

Profile Details

NPI number 1942233564
LBN Legal business name Shasha, Khalil I.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2006
Last updated Sep 1st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942233564 NPPES
Washington MEDICAID 1046292
Washington Other 0279857
Washington Other P00946005

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