Individual
JEFFREY SUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
417 SW 117TH AVE STE 200, PORTLAND, OR 97225-5924
(503) 216-1800
(503) 216-1810
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO195226
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/03/2015
Last updated
03/25/2021
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