Individual
MR. PETER J WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
14625 SW ALLEN BLVD, BEAVERTON, OR 97007-3600
(503) 643-2724
Mailing address
PO BOX 667, BANKS, OR 97106-0667
(503) 621-3604
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8536
OR
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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