Provider Demographics
NPI:1285990036
Name:KALU, RICHARD UWAKA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:UWAKA
Last Name:KALU
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 NW PALMBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7477
Mailing Address - Country:US
Mailing Address - Phone:610-563-5563
Mailing Address - Fax:
Practice Address - Street 1:9155 SW BARNES RD STE 231
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6653
Practice Address - Country:US
Practice Address - Phone:971-254-9884
Practice Address - Fax:503-206-8365
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD215228208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery