Provider Demographics
NPI:1992328637
Name:CHEUNG, MICHAEL CAM HUNG (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CAM HUNG
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4284 N MARYLAND AVE APT 315
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-3273
Mailing Address - Country:US
Mailing Address - Phone:510-415-4399
Mailing Address - Fax:
Practice Address - Street 1:305 SE CHKALOV DR STE 160
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5291
Practice Address - Country:US
Practice Address - Phone:360-227-8668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60951467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor