Healthcare Provider Details

I. General information

NPI: 1184558728
Provider Name (Legal Business Name): AMBER BUI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 MCGILCHRIST ST SE STE 130
SALEM OR
97302-1691
US

IV. Provider business mailing address

18051 SW LOWER BOONES FERRY RD APT 248
TIGARD OR
97224-7280
US

V. Phone/Fax

Practice location:
  • Phone: 971-304-2210
  • Fax:
Mailing address:
  • Phone: 504-939-4680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: