Basic Information
Provider Information
NPI: 1841493046
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HU
FirstName: MEITUCK
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 430 NE 16TH AVE
Address2: APT 220
City: PORTLAND
State: OR
PostalCode: 972322869
CountryCode: US
TelephoneNumber: 5034534193
FaxNumber:  
Practice Location
Address1: 2800 N VANCOUVER AVE
Address2: SUITE 230
City: PORTLAND
State: OR
PostalCode: 972271630
CountryCode: US
TelephoneNumber: 5034132901
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/06/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X16516ORY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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