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Individual

MR. ROLANDO LUIS CHONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MHT2

Contact information

Practice address
326 CARNELIA ST SE, SALEM, OR 97306-2077
(503) 581-2418
Mailing address
326 CARNELIA ST SE, SALEM, OR 97306-2077
(503) 581-2418

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
843689354
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
519207
OREGON HEALTH AUTHORITY
OR
Enumeration date
11/29/2019
Last updated
12/02/2019
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