SE Jung Shin MD Professional Corporation

NPI #1184829244 in Portland, Oregon

Provider Information

NPI Number: 1184829244
Entity Type: Organization
Organization Name: SE Jung Shin MD Professional Corporation
Primary Specialty: Emergency Medicine
Enumeration Date: Jun 19, 2007
Last Updated: Apr 16, 2015

Practice Location

Address: 13305 NW CORNELL ROAD, SUITE C
City: Portland
State: Oregon
ZIP Code: 97229
Phone: (503) 646-8500

Authorized Official

Name: DR. SE JUNG SHIN, M.D. PC
Title: PRESIDENT
Phone: (503) 646-8500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine - Emergency Medical Services — Emergency Medical Services	207PE0004X
Emergency Medicine - Pediatric Emergency Medicine — Pediatric Emergency Medicine	207PP0204X
Emergency Medicine	207P00000X	Primary

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