David Chan

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Portland, OR

NPI 1386480135 · NPPES record last updated Jul 2, 2024

Key facts

NPI
1386480135
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
6029 SE 48TH Ave
Portland, OR 97206-6109
Phone
(646) 520-9718
NPI assigned
Jul 2, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

6029 SE 48TH Ave
Portland, OR 97206-6109

Mailing address

6029 SE 48TH Ave
Portland, OR 97206-6109

Other providers in Portland, OR

All providers in Portland, OR · Student in an Organized Health Care Education/Training Program in Oregon

Sources for this page

Verify at the official NPI Registry.