Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD182232 | OR |
N | 111NI0900X | Internist | MD182232 | OR |
Y | 207RC0000X | Internist - Cardiovascular Disease | MD182232 | OR |
NPI | 1013200302 |
---|---|
Provider Name | Catherine Wong |
First Address | Portland, OR 97239-4501 |
Second Address | Portland, OR 97239-4501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2011 |
Last Update Date | 04/02/2022 |