Individual
DR. JACQUELINE MAHN KWAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-4500
(503) 494-1678
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-4500
(503) 494-1678
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
125066452
IL
207VG0400X
Gynecology Physician
MD204040
OR
Other
Enumeration date
01/17/2015
Last updated
05/29/2021
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