Individual
DR. KEN KYUNG-HOON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 NW NORTHRUP ST STE 600, PORTLAND, OR 97209
(503) 223-3104
(503) 223-4619
Mailing address
847 NE 19TH AVE STE 300, PORTLAND, OR 97232-2686
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD19438
OR
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD19438
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151115
—
OR
Enumeration date
08/03/2006
Last updated
06/06/2023
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