Healthcare Provider Details

I. General information

NPI: 1962538991
Provider Name (Legal Business Name): LENA F. KUO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 04/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 N VANCOUVER AVE SUITE 165
PORTLAND OR
97227-1630
US

IV. Provider business mailing address

2800 N VANCOUVER AVE SUITE 165
PORTLAND OR
97227-1630
US

V. Phone/Fax

Practice location:
  • Phone: 503-413-2902
  • Fax: 503-413-1623
Mailing address:
  • Phone: 503-413-2902
  • Fax: 503-413-1623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00044498
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberMD27703
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD27703
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: