NPI 1003266891

Derek Sun

Practitioner Adult Companion Portland, OR

Practice location

Address: 847 NE 19th Ave Suite 100, Portland, OR 97232-2684
Phone: (503) 238-0769
Mailing address: PO Box 8459, Portland, OR 97207-8459

Registered specialties

Adult Companion Primary

Nursing Service Related Providers Taxonomy 372600000X

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Registry record

NPI: 1003266891
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Jun 2016
Record last updated: 13 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.