Individual
KELLY DENISE CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9135 SW BARNES RD, SUITE 961, PORTLAND, OR 97225
(503) 292-0848
Mailing address
PO BOX 22009, PORTLAND, OR 97269-2009
(503) 558-7372
(503) 344-5140
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD19039
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065271
—
OR
Enumeration date
06/23/2006
Last updated
01/21/2022
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