Individual
DR. ALIX JISUN LEEMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1616 SW SUNSET BLVD STE C, PORTLAND, OR 97239-2641
(503) 246-6785
Mailing address
1616 SW SUNSET BLVD STE C, PORTLAND, OR 97239-2641
(503) 246-6785
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D10990
OR
Other
Enumeration date
12/05/2018
Last updated
03/17/2021
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