Individual
LONG K DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
14700 SE MCLOUGHLIN BLVD, PORTLAND, OR 97267-1417
(503) 652-4133
Mailing address
12330 SE BUSH ST APT 14, PORTLAND, OR 97236-3477
(503) 758-9279
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PI-0010663
OR
Other
Enumeration date
02/02/2013
Last updated
02/02/2013
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