Individual
HEH SHIN RACHER KWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD STE 201, TIGARD, OR 97224-7259
(503) 216-0500
(971) 712-2120
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD29285
OR
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
MD29285
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500607347
—
OR
Enumeration date
08/15/2007
Last updated
12/14/2021
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