Individual
JUDY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
4400 NE HALSEY ST, PORTLAND, OR 97213-1545
(503) 893-6900
Mailing address
4400 NE HALSEY ST, PORTLAND, OR 97213-1545
(503) 893-6900
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
5302040260
MI
183500000X
Pharmacist
PH60555418
WA
183500000X
Pharmacist
Primary
RPH-0015510
OR
Other
Enumeration date
07/16/2015
Last updated
09/21/2021
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