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NPI Code Detail

MEDICARE: DR. LOANN M WONG PHARMD

MEDICARE: DR. LOANN M WONG PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist8049OR

General Provider Information

NPI Number : 1013269448
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOANN M WONG PHARMD
Provider Business Mailing Address
First Line : 3988 NW CRAIG DR
Second Line :
City : BEAVERTON
State : OR
Zip : 97006-7293
Country : US
Telephone Number : 503-531-9468
Fax Number :
Provider Business Practice Location Address
First Line : 5119 NE 57TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97218-2584
Country : US
Telephone Number : 503-215-9910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2012
Last Update Date : 10/09/2012

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Directions to “ DR. LOANN M WONG PHARMD” Practice Location

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