Individual
MR. GORDON JIN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
3710 SW US VETERANS HOSPITAL ROAD, PORTLAND, OR 97239
(503) 220-8262
Mailing address
4075 SW 107TH AVE APT 13, BEAVERTON, OR 97005-3255
(503) 646-5576
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36389
TX
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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