Individual
JONATHAN DANIEL WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
463 N VILLAGE MEADOWS RD, SISTERS, OR 97759-2643
(541) 730-9279
Mailing address
463 N VILLAGE MEADOWS RD, SISTERS, OR 97759-2643
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
214228
OR
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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