Individual
JEREMIAH LUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7772
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7772
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
3832
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/06/2018
Last updated
11/15/2024
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