Individual
LY PONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10000 SE 82ND AVE, HAPPY VALLEY, OR 97086-2304
(503) 788-4757
(503) 788-5759
Mailing address
10000 SE 82ND AVE, HAPPY VALLEY, OR 97086-2304
(503) 788-4757
(503) 788-5759
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9823
OR
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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