Provider Demographics
NPI:1093892648
Name:KOHN, AIMEE D (MD)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:D
Last Name:KOHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 SE MAIN ST STE 350
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2474
Mailing Address - Country:US
Mailing Address - Phone:971-262-9800
Mailing Address - Fax:971-262-9899
Practice Address - Street 1:10000 SE MAIN ST STE 350
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2474
Practice Address - Country:US
Practice Address - Phone:971-262-9800
Practice Address - Fax:971-262-9899
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040137207RH0003X
MO2015032395207RH0003X
ORMD192698207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2015032395OtherLICENSE
WAI51637Medicare UPIN
WA8859733Medicare PIN
WA8907370Medicare PIN
WA8907370Medicare PIN
WA0291714OtherL&I