Individual
TRUNG PHU CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4816 NW BETHANY BLVD, PORTLAND, OR 97229-9254
(888) 227-3312
(971) 282-0100
Mailing address
PO BOX 2908, PORTLAND, OR 97208-2908
(252) 075-1554
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA174588
OR
Other
Enumeration date
09/15/2014
Last updated
03/07/2024
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