Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD151122 | OR |
NPI | 1033379862 |
---|---|
Provider Name | Dr. Amy Li Rong Zhu |
First Address | Portland, OR 97232-2684 |
Second Address | Portland, OR 97220-9428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 17/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033379862 | (05) | WA |
500648506 | (05) | OR |