Healthcare Provider Details

I. General information

NPI: 1518329804
Provider Name (Legal Business Name): GEFEI ZHU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALEX ZHU M.D.

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 06/18/2023
Certification Date: 06/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 SW 117TH AVE STE 100
PORTLAND OR
97225-5924
US

IV. Provider business mailing address

PO BOX 3158
PORTLAND OR
97208-3158
US

V. Phone/Fax

Practice location:
  • Phone: 503-216-8980
  • Fax:
Mailing address:
  • Phone: 503-215-6494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD208582
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD61085510
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: