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General NPI Number Information
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NPI Number | 1992303317
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Entity Type | Organization
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Legal Business Name | PACIFIC ALLERGY LLC
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 5040 SW GRIFFITH DR STE 201
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City | BEAVERTON
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State | OR
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Zip | 97005-8721
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Country | US
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Telephone | 503-486-4481
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Fax | 570-243-0932
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Provider Business Mailing Address
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Address Line | PO BOX 10562
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City | PORTLAND
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State | OR
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Zip | 97296-0562
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER, OWNER
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Name | DR. ALEXANDER CHAN YU
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Credential | MD, PHD
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Telephone | 503-486-4481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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