Individual
GAY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 NE 102ND AVE, PORTLAND, OR 97220-4167
(503) 894-9005
(503) 719-4178
Mailing address
135 NE 102ND AVE, PORTLAND, OR 97220-4167
(503) 894-9005
(503) 719-4178
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
092000304RN
OR
363L00000X
Nurse Practitioner
Primary
201150032NP
OR
363LF0000X
Family Nurse Practitioner
201150032NP
OR
Other
Enumeration date
08/04/2009
Last updated
06/30/2021
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