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General NPI Number Information
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NPI Number | 1578752846
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Entity Type | Individual
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Provider Name | EDNA KUNG M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 511 SW 10TH AVE SUITE 613
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City | PORTLAND
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State | OR
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Zip | 97205-2732
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Country | US
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Telephone | 503-222-7333
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Fax | 503-517-8588
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Provider Business Mailing Address
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Address Line | 4110 SE HAWTHORNE BLVD PMB 232
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City | PORTLAND
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State | OR
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Zip | 97214-5246
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Country | US
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Telephone | 503-734-5381
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Fax | 503-517-8588
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G64903
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD27996
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License Number State | OR
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