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General NPI Number Information
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NPI Number | 1134447758
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Entity Type | Organization
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Legal Business Name | PORTLAND SURGEONS, PC
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 5050 NE HOYT ST SUITE 523
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City | PORTLAND
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State | OR
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Zip | 97213-2944
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Country | US
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Telephone | 503-215-3550
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 23200
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City | PORTLAND
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State | OR
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Zip | 97281-3200
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Country | US
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Telephone | 503-968-4642
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Fax |
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Authorized Official
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Title or Position | OWNER/MD
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Name | KELVIN YU
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Credential | MD
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Telephone | 503-215-3550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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