Individual
RAYOUNG CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4805 NE GLISAN ST, STE 6N40, PORTLAND, OR 97213-2933
(503) 215-5696
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60356518
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
201507582NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500698047
—
OR
01
—
P01687570
RR MEDICARE - PH&S - OREGON (PMG)
OR
Enumeration date
06/07/2013
Last updated
02/19/2021
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