Basic Information
Provider Information
NPI: 1447230594
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HYUN
FirstName: CHRIS
MiddleName: BYUNG
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 SW 13TH AVE
Address2:  
City: PORTLAND
State: OR
PostalCode: 972051902
CountryCode: US
TelephoneNumber: 5032210161
FaxNumber:  
Practice Location
Address1: 9250 SW HALL BLVD
Address2:  
City: TIGARD
State: OR
PostalCode: 972236857
CountryCode: US
TelephoneNumber: 5032930161
FaxNumber: 5034523200
Other Information
ProviderEnumerationDate: 01/17/2006
LastUpdateDate: 11/12/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/12/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100XMD26315ORY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


Home