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General NPI Number Information
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NPI Number | 1033495601
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Entity Type | Individual
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Provider Name | PAULA MARIE KWONG PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 12/31/2015
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Provider Practice Location Address
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Address Line | 3031 KILLDEER AVE SE
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City | ALBANY
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State | OR
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Zip | 97322-5325
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Country | US
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Telephone | 541-918-7042
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Fax | 541-918-7061
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Provider Business Mailing Address
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Address Line | 3031 KILLDEER AVE SE
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City | ALBANY
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State | OR
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Zip | 97322-5325
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Country | US
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Telephone | 541-918-7042
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Fax | 541-918-7061
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 7568
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 7568
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License Number State | OR
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