Individual
KIM CHAMPION LU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MAILCODE L223A, PORTLAND, OR 97239-3011
(503) 494-4373
(503) 494-8884
Mailing address
3181 SW SAM JACKSON PARK RD, MAILCODE L223A, PORTLAND, OR 97239-3011
(503) 494-4373
(503) 494-8884
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD25911
OR
208C00000X
Colon & Rectal Surgery Physician
Primary
MD25911
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213553
—
OR
Enumeration date
08/02/2006
Last updated
09/17/2020
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