Healthcare Provider Details

I. General information

NPI: 1891787396
Provider Name (Legal Business Name): DENNIS HONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 NW 22ND AVE SUITE 500
PORTLAND OR
97210-3057
US

IV. Provider business mailing address

975 SE SANDY BLVD SUITE 200
PORTLAND OR
97214-1308
US

V. Phone/Fax

Practice location:
  • Phone: 503-227-5050
  • Fax: 503-227-2462
Mailing address:
  • Phone: 503-963-2846
  • Fax: 503-963-9505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD24818
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: