Provider Demographics
NPI:1699200899
Name:WU, JOSEPH CHIN (RN)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CHIN
Last Name:WU
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 NW 139TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-5749
Mailing Address - Country:US
Mailing Address - Phone:503-718-4065
Mailing Address - Fax:
Practice Address - Street 1:400 NW 139TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5749
Practice Address - Country:US
Practice Address - Phone:503-718-4065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1644956163W00000X
OR200942181RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse