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Individual

DONG LIM JI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
15640 NW LAIDLAW RD, SUITE 102, PORTLAND, OR 97229-3828
(503) 764-0100
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23983
AL
207Q00000X
Family Medicine Physician
9701776
NC
207Q00000X
Family Medicine Physician
Primary
MD126217
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500611995
OR
01
P00940162
RR MEDICARE
OR
Enumeration date
12/20/2006
Last updated
10/02/2020
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