Organization
OREGON COSMETIC AND RECONSTRUCTIVE CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA JENQ MD (OWNER)
(503) 400-6622
Entity
Organization
Contact information
Practice address
10202 SE 32ND AVE, SUITE 702, MILWAUKIE, OR 97222-3610
(503) 400-6622
(503) 400-6622
Mailing address
PO BOX 66500, PO, PORTLAND, OR 97290-6500
(503) 657-8663
(503) 723-3180
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
06/18/2010
Last updated
09/22/2010
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