Individual
SANDY H FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
D74696
MD
208C00000X
Colon & Rectal Surgery Physician
Primary
MD205379
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058314600
—
MD
05
—
500796812
—
OR
Enumeration date
05/22/2007
Last updated
01/20/2023
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