Basic Information
| Provider Information | |||||||||
| NPI: | 1912458241 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WU | ||||||||
| FirstName: | YUNUO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4400 NE HALSEY ST | ||||||||
| Address2: | 4TH FLOOR, BUILDING 2 | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972131545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038936900 | ||||||||
| FaxNumber: | 5038936913 | ||||||||
| Practice Location | |||||||||
| Address1: | 4400 NE HALSEY ST | ||||||||
| Address2: | 4TH FLOOR, BUILDING 2 | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972131545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038936900 | ||||||||
| FaxNumber: | 5038936913 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2016 | ||||||||
| LastUpdateDate: | 10/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 14981 | NE | N | Pharmacy Service Providers | Pharmacist | 1835P2201X | RPH-0015494 | OR | Y |
No ID Information.