Provider Demographics
NPI:1679585558
Name:LIM, CHRISTOPHER NYENHON (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:NYENHON
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5050 NE HOYT ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2991
Mailing Address - Country:US
Mailing Address - Phone:503-231-0377
Mailing Address - Fax:503-231-2816
Practice Address - Street 1:5050 NE HOYT ST
Practice Address - Street 2:SUITE 410
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2991
Practice Address - Country:US
Practice Address - Phone:503-231-0377
Practice Address - Fax:503-231-2816
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD11657208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1629080510OtherORGANIZATION NPI
OR233858Medicaid
OR233858Medicaid
OR1629080510OtherORGANIZATION NPI