Chung, Kelly Denise
Chung, Kelly Denise is an individual health care provider with primary practice located at 9135 Sw Barnes Rd Suite 961, Portland OR 97225. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Chung, Kelly Denise can be contacted via phone (503) 292-0848.Contact Information
Primary practice address
9135 Sw Barnes Rd Suite 961
Portland OR 97225
Phone: (503) 292-0848
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD19039 | Oregon |
Profile Details
| NPI number | 1760418743 |
|---|---|
| LBN Legal business name | Chung, Kelly Denise |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Jan 21st, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760418743 | NPPES |
| Oregon | MEDICAID | 065271 |
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