Individual
KENNY PHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 N GRAHAM ST STE 580, PORTLAND, OR 97227-2003
(503) 528-0704
Mailing address
501 N GRAHAM ST STE 580, PORTLAND, OR 97227-2003
(503) 528-0704
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
07/21/2022
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