SE JUNG SHIN MD PROFESSIONAL CORPORATION
Osteopathic Medicine at Cornell Rd, Portland, OR

License number
Oregon 36696
Category
Osteopathic Medicine
Type
Emergency Medicine
License number
Oregon 36696
Category
Osteopathic Medicine
Type
Emergency Medical Services
License number
Oregon 36696
Category
Osteopathic Medicine
Type
Pediatric Emergency Medicine
Owner
Name: DR. SE JUNG SHIN M.D. PC
Title: PRESIDENT
Phone: (503) 646-8500
Address
Address
13305 NW Cornell Rd SUITE C, Portland, OR 97229
National Provider ID: 1184829244
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SE JUNG SHIN MD PROFESSIONAL CORPORATION

Portland, OR

Industry:
Medical Doctor's Office
Doing business as:
SE Jung Shin Professional Corporation
Registration:
May 2, 2007
Addresses:
13305 NW Cornell Rd STE C, Portland, OR 97229 (Physical)
Greg Carroll 13305 Nw Cornell Rd STE C, Portland, OR 97229 (Mailing)
State ID:
43312693
Business type:
DOMESTIC PROFESSIONAL CORPORATION
President:
Sejung Shin (President)
Agent:
Corporation Service Company,1127 Broadway St NE STE 310, Salem, OR 97301 (Physical)

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