Individual
SHAN-AI KWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1261 NE 27TH ST, GRESHAM, OR 97030-3033
(503) 307-6802
Mailing address
1261 NE 27TH ST, GRESHAM, OR 97030-3033
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5613
OR
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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