Individual
MICHAEL J CHA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17055 RUBEN LN, SANDY, OR 97055-9276
(503) 668-8002
(503) 668-5246
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD23044
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153290
WA LABOR & INDUSTRIES
WA
05
—
287340
—
OR
05
—
8360760
—
WA
Enumeration date
04/20/2006
Last updated
07/08/2007
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