Provider Demographics
NPI:1821175068
Name:WU, JOANNE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 SE 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5749
Mailing Address - Country:US
Mailing Address - Phone:503-659-4988
Mailing Address - Fax:
Practice Address - Street 1:6327 SE MILWAUKIE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5418
Practice Address - Country:US
Practice Address - Phone:503-659-4988
Practice Address - Fax:503-353-1297
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27061207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR274387Medicaid
OR274387Medicaid