Healthcare Provider Details

I. General information

NPI: 1144480484
Provider Name (Legal Business Name): JOYCE MICHELLE KOH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 NW 11TH ST STE M206
HERMISTON OR
97838-6941
US

IV. Provider business mailing address

PO BOX 18255
IRVINE CA
92623-8255
US

V. Phone/Fax

Practice location:
  • Phone: 541-667-3804
  • Fax: 541-667-0192
Mailing address:
  • Phone: 410-929-5569
  • Fax: 877-929-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD212643
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0074501
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number4301510763
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: