Individual
SARAH KUPPENBENDER KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4411 SW VERMONT ST, PORTLAND, OR 97219-1020
(503) 494-9992
Mailing address
12960 SW DOUGLAS ST, PORTLAND, OR 97225-4548
(503) 551-9099
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201706888NP-PP
OR
Other
Enumeration date
08/24/2017
Last updated
04/25/2019
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