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NPI Code Detail

MEDICARE: EVAN CHAN

MEDICARE: EVAN CHAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171R00000XInterpreter982811-90OR

General Provider Information

NPI Number : 1871997148
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVAN CHAN
Provider Business Mailing Address
First Line : 4300 NE FREMONT ST
Second Line : STE 230
City : PORTLAND
State : OR
Zip : 97213-1100
Country : US
Telephone Number : 503-477-7907
Fax Number : 503-477-7913
Provider Business Practice Location Address
First Line : 4300 NE FREMONT ST
Second Line : STE 230
City : PORTLAND
State : OR
Zip : 97213-1100
Country : US
Telephone Number : 503-477-7907
Fax Number : 503-477-7913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2014
Last Update Date : 10/15/2014

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Directions to “ EVAN CHAN ” Practice Location

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