Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | MD184313 | OR |
N | 2084N0400X | Neurologist | 21515 | NH |
Y | 2084N0400X | Neurologist | MD184313 | OR |
NPI | 1063779213 |
---|---|
Provider Name | Ricky Chen |
First Address | Portland, OR 97208-3158 |
Second Address | Portland, OR 97225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2012 |
Last Update Date | 04/10/2021 |