Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD192051 | OR |
NPI | 1003235557 |
---|---|
Provider Name | Amy Ying Tong |
First Address | Portland, OR 97269-2009 |
Second Address | Portland, OR 97209-1614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2014 |
Last Update Date | 20/02/2021 |