Individual
JIN HWA CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1649 SW 173RD TER, BEAVERTON, OR 97003-4262
(503) 810-1946
Mailing address
1649 SW 173RD TER, BEAVERTON, OR 97003-4262
(503) 810-1946
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
739088
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
739088
HOMECARE WORKER ID #
OR
Enumeration date
10/31/2016
Last updated
10/31/2016
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