Provider Demographics
NPI:1356431464
Name:CHOW, HSICHAO (MD)
Entity type:Individual
Prefix:MR
First Name:HSICHAO
Middle Name:
Last Name:CHOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 SE MAIN ST 112
Mailing Address - Street 2:GASTROENTEROLOGY ASSOC
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2441
Mailing Address - Country:US
Mailing Address - Phone:503-255-3054
Mailing Address - Fax:
Practice Address - Street 1:10000 SE MAIN ST 112
Practice Address - Street 2:GASTROENTEROLOGY ASSOC
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2441
Practice Address - Country:US
Practice Address - Phone:503-255-3054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27289207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR276110Medicaid
ORR137585Medicare PIN
ORP00478468Medicare PIN
ORA50769Medicare UPIN