Individual
DR. NICHOLAS ROBERT MONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T., D.P.T., A.T.C.
Contact information
Practice address
735 SW 158TH AVE # 160, BEAVERTON, OR 97006-4952
(503) 597-0035
(503) 296-2985
Mailing address
735 SW 158TH AVE # 160, BEAVERTON, OR 97006-4952
(503) 597-0035
(503) 296-2985
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05888
OR
2255A2300X
Athletic Trainer
RT004181
PA
Other
Enumeration date
10/15/2009
Last updated
02/20/2010
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