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Individual

CHARLES BONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1201 SE 223RD AVE STE 160, GRESHAM, OR 97030-2577
(503) 492-2020
Mailing address
12822 SE 157TH AVE UNIT 202, HAPPY VALLEY, OR 97086-4333

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
27OA00651800
NJ
152W00000X
Optometrist
Primary
AT4555
OR

Other

Enumeration date
04/22/2014
Last updated
06/14/2021
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