Individual
ALEXANDER FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, AGACNP-BC
Contact information
Practice address
501 N GRAHAM ST STE 220, PORTLAND, OR 97227-2014
(503) 414-6200
Mailing address
501 N GRAHAM ST STE 220, PORTLAND, OR 97227-2014
(503) 413-6200
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
201802224RN
OR
363LA2100X
Acute Care Nurse Practitioner
201802224RN
OR
363LA2100X
Acute Care Nurse Practitioner
Primary
202113265NP-PP
OR
Other
Enumeration date
09/21/2021
Last updated
06/02/2023
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