Provider Demographics
NPI:1659539096
Name:LAOCHAMROONVORAPONGSE, DEAN LI-JIN (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:LI-JIN
Last Name:LAOCHAMROONVORAPONGSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DEAN
Other - Middle Name:
Other - Last Name:LAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1720 SW 4TH AVE
Mailing Address - Street 2:616
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5512
Mailing Address - Country:US
Mailing Address - Phone:917-848-5581
Mailing Address - Fax:
Practice Address - Street 1:1720 SW 4TH AVE
Practice Address - Street 2:616
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5512
Practice Address - Country:US
Practice Address - Phone:917-848-5581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-31
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR153816207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology