Sim, Felix Wiyanto

Sim, Felix Wiyanto is an individual health care provider with primary practice located at 1015 Nw 22Nd Ave , Portland OR 97210-3025. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Sim, Felix Wiyanto can be contacted via phone (503) 413-4656.

Contact Information

Primary practice address
1015 Nw 22Nd Ave Portland OR 97210-3025
Phone: (503) 413-4656
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X FE172458 Oregon

Profile Details

NPI number 1104209386
LBN Legal business name Sim, Felix Wiyanto
Credentials MBBS, BDS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2015
Last updated Jul 7th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104209386 NPPES
Oregon Other FE172458 OREGON MEDICAL LICENCE

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