Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD173315 | OR |
NPI | 1033435961 |
---|---|
Provider Name | Dr. Jacqueline Ka-Wan Ng |
First Address | Portland, OR 97269-2009 |
Second Address | Lake Oswego, OR 97035-8863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2010 |
Last Update Date | 21/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500655454 | (05) | OR |