Individual
SIMON K CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6445 N GREELEY AVE, PORTLAND, OR 97217-5023
(503) 285-6607
(503) 285-3195
Mailing address
6445 N GREELEY AVE, PORTLAND, OR 97217-5023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D018670
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060512
—
OR
01
—
080058600
RR PIN
—
Enumeration date
05/16/2006
Last updated
05/03/2013
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