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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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INKLAB, MAHAKIT       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 1013 E EDISON AVE
SUNNYSIDE WA 98944

Address last updated on 3/2/2023
Phone #: (509) 837-1587
Fax #:
County: NOT OKLAHOMA
License: 31254
Dated: 4/13/2015
Expires: 4/1/2024
License Type: Medical Doctor
Specialty: HEMATOLOGY/ONCOLOGY
Internal Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Chulalongkorn Univ, Fac Of Med, Bangkok, Thailand
Graduated: 3 / 2005
CME Year: 2024
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF INTERNAL MEDICINE
AMERICAN BOARD OF INTERNAL MEDICINE - Hematology
AMERICAN BOARD OF INTERNAL MEDICINE - Medical Oncology
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1013 E EDISON AVE
SUNNYSIDE WA 98944

Phone #: (509) 837-1587
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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