Chan, Simon K

Chan, Simon K is an individual health care provider with primary practice located at 6445 N Greeley Ave , Portland OR 97217-5023. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Chan, Simon K can be contacted via phone (503) 285-6607.

Contact Information

Primary practice address
6445 N Greeley Ave Portland OR 97217-5023
Phone: (503) 285-6607
Fax: (503) 285-3195
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D018670 Oregon

Profile Details

NPI number 1841242195
LBN Legal business name Chan, Simon K
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated May 3rd, 2013 - about 12 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 1841242195 NPPES
Other 080058600 RR PIN
MEDICAID 060512 RR PIN

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