Park, Jae O
Park, Jae O is an sole proprietor health care provider with primary practice located at 14455 Sw Allen Blvd Suite 101, Beaverton OR 97005-4428. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Park, Jae O can be contacted via phone (503) 643-2120.Contact Information
Primary practice address
14455 Sw Allen Blvd Suite 101
Beaverton OR 97005-4428
Phone: (503) 643-2120
Fax: (503) 643-1034
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD13752 | Oregon |
Profile Details
| NPI number | 1780621805 |
|---|---|
| LBN Legal business name | Park, Jae O |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2006 |
| Last updated | Feb 24th, 2017 - about 8 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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