Healthcare Provider Details

I. General information

NPI: 1699902551
Provider Name (Legal Business Name): OREGON FERTILITY INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9370 SW GREENBURG RD SUITE 412
PORTLAND OR
97223-5442
US

IV. Provider business mailing address

9370 SW GREENBURG RD SUITE 412
PORTLAND OR
97223-5442
US

V. Phone/Fax

Practice location:
  • Phone: 503-292-7734
  • Fax: 503-292-7735
Mailing address:
  • Phone: 503-292-7734
  • Fax: 503-292-7735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AIMEE L CHANG
Title or Position: OWNER
Credential: MD
Phone: 503-292-7734