Provider Demographics
NPI:1972512291
Name:ZHAI, JUAN (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:
Last Name:ZHAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35147
Mailing Address - Street 2:#1801
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-5147
Mailing Address - Country:US
Mailing Address - Phone:503-299-9906
Mailing Address - Fax:503-225-9002
Practice Address - Street 1:707 SW WASHINGTON ST
Practice Address - Street 2:STE 700
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3536
Practice Address - Country:US
Practice Address - Phone:503-299-9906
Practice Address - Fax:503-225-9002
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD22940207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR050079769OtherRR MEDICARE
AZ686718Medicaid
WA8271017Medicaid
OR287817Medicaid
ID807051100Medicaid
CAXPY206304Medicaid
AZ686718Medicaid
H31829Medicare UPIN
OR108849Medicare PIN