Individual
CANDACE HOPE KANANI CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(808) 271-2983
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(808) 271-2983
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IN401O2T
—
OR
Enumeration date
08/15/2022
Last updated
08/15/2022
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