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NPI Code Detail

MEDICARE: DR. JULIA ANN WONG-NGAN PH.D.

MEDICARE: DR. JULIA ANN WONG-NGAN PH.D.
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
1103G00000XClinical Neuropsychologist708OR
2103TC0700XClinical Psychologist708OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245327501
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIA ANN WONG-NGAN PH.D.
Provider Business Mailing Address
First Line : 205 SE SPOKANE ST STE 300
Second Line :
City : PORTLAND
State : OR
Zip : 97202-6487
Country : US
Telephone Number : 503-242-0490
Fax Number : 503-238-7450
Provider Business Practice Location Address
First Line : 205 SE SPOKANE ST STE 300
Second Line :
City : PORTLAND
State : OR
Zip : 97202-6487
Country : US
Telephone Number : 503-242-0490
Fax Number : 503-238-7450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 03/07/2017

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