Individual
DEBRAH A WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1111 NE 99TH AVE, PORTLAND, OR 97220-9428
(503) 963-3030
(503) 963-3005
Mailing address
975 SE SANDY BLVD, SUITE 200, PORTLAND, OR 97214-1308
(503) 963-2846
(503) 963-9505
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
097006867N1 FNP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276692
—
OR
05
—
9643966
—
WA
Enumeration date
08/24/2005
Last updated
08/05/2008
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