Provider Demographics
NPI:1386186716
Name:LUI, EDDIE CHAI YUEN
Entity Type:Individual
Prefix:MR
First Name:EDDIE CHAI YUEN
Middle Name:
Last Name:LUI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 SW GLENCREEK CT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-9330
Mailing Address - Country:US
Mailing Address - Phone:503-929-2431
Mailing Address - Fax:
Practice Address - Street 1:8235 SW GLENCREEK CT
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-9330
Practice Address - Country:US
Practice Address - Phone:503-929-2431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR164936Medicaid