Individual
DR. STEPHANIE J MENGDEN KOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12254 SW GARDEN PL, TIGARD, OR 97223-8246
(503) 906-7300
(503) 245-8219
Mailing address
PO BOX 230457, TIGARD, OR 97281-0457
(503) 906-7300
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD28731
OR
207ND0900X
Dermatopathology Physician
Primary
MD28731
OR
Other
Enumeration date
11/25/2005
Last updated
11/02/2010
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