Provider Demographics
NPI:1699921387
Name:SADIQ, HUMA I (MD)
Entity type:Individual
Prefix:
First Name:HUMA
Middle Name:I
Last Name:SADIQ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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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:503-215-6631
Mailing Address - Fax:503-215-6271
Practice Address - Street 1:315 SE STONEMILL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6998
Practice Address - Country:US
Practice Address - Phone:360-816-2700
Practice Address - Fax:360-816-2710
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60150813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1699921387OtherNPI
WAMD60150813OtherLICENSE NUMBER