Individual
JONATHAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
19767 SW 72ND AVE, STE 103, TUALATIN, OR 97062-8354
(503) 620-6480
Mailing address
19767 SW 72ND AVE, STE 103, TUALATIN, OR 97062-8354
(503) 620-6480
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3811
OR
111NI0900X
Internist Chiropractor
3811
OR
111NS0005X
Sports Physician Chiropractor
3811
OR
111NX0100X
Occupational Health Chiropractor
3811
OR
Other
Enumeration date
03/20/2009
Last updated
09/11/2018
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