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General NPI Number Information
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NPI Number | 1437527819
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Entity Type | Individual
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Provider Name | CHRISTINE ROSE WONG PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 955 SE BASELINE ST
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City | HILLSBORO
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State | OR
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Zip | 97123-4207
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Country | US
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Telephone | 503-615-8384
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Fax |
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Provider Business Mailing Address
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Address Line | 11700 SW BUTNER RD APT 224
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City | PORTLAND
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State | OR
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Zip | 97225-5740
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Country | US
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Telephone | 626-372-3255
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Fax |
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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 | RPH-0014889
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License Number State | OR
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