Organization
REVIANCE PORTLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CHAN MD (OWNER)
(503) 953-1230
Entity
Organization
Contact information
Practice address
9280 SE SUNNYBROOK BLVD STE 301, CLACKAMAS, OR 97015-9353
(503) 953-1230
Mailing address
9280 SE SUNNYBROOK BLVD STE 301, CLACKAMAS, OR 97015-9353
(503) 953-1230
Taxonomy
Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
—
—
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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