Individual
KHAN CHAICHANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3157 SW FAIRMOUNT BLVD, PORTLAND, OR 97239-1441
(801) 414-5090
Mailing address
3157 SW FAIRMOUNT BLVD, PORTLAND, OR 97239-1441
(801) 414-5090
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
266820
MA
207L00000X
Anesthesiology Physician
Primary
MD184749
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500733898
—
OR
Enumeration date
04/16/2012
Last updated
11/20/2023
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